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TRANSACTIONS 

OF THE 

MEDICAL ASSOCIATION 



STATE OF ALABAMA. 

(THE STATE BOARD OP HBAI.TH.> 
ORGANIZED 1S47— MEETING OF 1901. 



SBL^MA, APRIL, 16-19. 






' ' r 






' u :^ .'i M 



1901 



THE MEDICAL ASSOCIATION 

OP THE 

STATE OF ALABAMA. 



PROGRAMME OF THE ANNUAL SESSION, 

APRIL 16-10. 1001 

Y. M. C. A. HALL, SELMA, ALA. 



COMMITTEB OF ARRANGEMENTS. 

Samuel Q. Oat, M. D., Chairman. 
John P. Fubniss, M. D. Clement Ritteb, M. D. 



FIRST DAY— TUESDAY, APRIL 16. 
MoBNiNG Session. 

1. Call to order at 12 M. by the President-— Russell McWhobteb 

Cunningham, M. D., Ensley. 

2. Prayer — ^A. J. Dickinson, D. D. 

3. Address of Welcome — ^W. MoL. Pnrs, M. D., President Dallas 

County Medical Society. 

4. Address of Welcome — ^Hon. A. L. McLiEod, Mayor of Selma. 

5. Annual Message of the President — ^R. M. Cunningham, M. D., 

Ensley. 

6. Report of Senior Vice-President — Samuel G. Gat, M. D., Selma. 

7. Report of Junior Vice-President — ^William T. Pbide, M. D., 

Madison. 

8. Report of the Secretary — G. P. Waller, M. D., Montgomery. 

9. Report of the Treasurer — ^H. G. Perbt, M. D., Greensboro. 

10. Report of the Publishing Committee. 

11. Report of Special Committees. 

12. Miscellaneous Business. 
Adjournment 



I THE MEDICAL ASSOCIATION OF ALABAMA. 

Evening Session. 

1. Call to order at 8 p. m. 

2. Historian's Address — Jesse Gbat Palmeb, M. D., Opelika. 

BBGULAB BEPOBTS. 

3. The Future Outlook of Medicine is Toward Prevention — ^R. C. 

Bankston, M. D., Birmingham. 

4. Pernicious Vomiting in Pregnancy — M. B. Cameron, M. D., 

Sumterville. 
6. The Therapeutic Uses of Water — ^A. M. Siovall, M. D., Jasper. 
6. Ovarian Cysts — ^R. S. Hill, M. D., Montgomery. 
Adjournment. 



SECOND DAY— WEDNESDAY, APRIL 17. 

1. Call to order at 9 A. M. 

2. Unfinished Business. 

CONTINUATION OF BBOULAB BEPOBTS. 

3. The Pathology and Treatment of Retro-Uterine Displacements — 

J. A. QoGOANS, M. D., Alexander City. 

4. Endometritis, its Treatment in the Home, with Report of Cases 

— C. S. Chenault, M. D., Mt. Hope. 

5. Reflex Neuroses in Women — ^E. B. Wabd, M. D., Selma. 

11 A. M. — SPECIAL OBDEB. 

6. Jerome Cochran Lecture — ^William Osleb M. D., L. L. D., Bal- 

timore, Md. 

7. Acute Entero-Colitis in Infancy — L. W. Johnston, M. D., Tus- 

kegee. 

8. Pathological Conditions Causing Abortion and Premature La- 

bor, with Reports of Cases — F. A. Webb, M. D., Calvert 

9. Moral and Legal Responsibility in Paranoia and other Abnor- 

mal Mental States — ^W. O. Somebville, M. D., Tuscaloosa. 

10. Mortality in our Prison Population — Judson Davie, M. D., 

Cowikee. 

11. The Prevention of Infectious Diseases — ^T. A. Cabet, M. D., 

Albertville. 
Adjournment. 

Aftebnoon Session. 
1. Call to order at 3 p. m. 



PROGRAJiMJB OF TtiB ANKUAL 8E88I0N. g 

OOimNUATION OF BBOULAB BEFOBTS. 

2. What iB the best Closure and Dressing in Aseptic Cases? — 

GoLDSBT KiNGy M. D., Solma. 

3. The Microscope In the Hands of the €toneral Practitioner — G. 

Heustis Fonde, M. D., Mobile. 

4. Peculiar Forms of Malaria — H. T. Inge, M. D., Mobile. 

6. Hydrocephalus; Its most Logical Theory, and the Operation 
Based on Same — ^H. M. Hunter, M. D., Union Springs. 

6. The Diseases of the Tennessee Valley — M. W. Mubray, M. D., 

New Decatur. 

7. Climatic BfTects in Talladega County on Diseases Common in 

Alabama — S. W. Welch, M. D., Talladega. 
Adjournment. 

Byenino Session. 

1. Call to order at 8 P. M., Opera House. 

2. Monitor's Address — ^W. B. B. Davis, M. D., Birmingham. 

3. Annual Oration — W. O. Habribon, M. D., Talladega. 
Adjournment 

Followed by a luncheon at Hotel Albert, tendered by Dallas 
County Medical Society. 



THIRD DAY— THURSDAY, APRIL 18. 

1. Call to order at 9 A. M. 

2. Unfinished Business. 

VOLUNTEEB PAPEBS. 

3. The Widal Reaction in Typhoid Fever — E«doab A. Jones, M. D., 

Birmingham. 

4. AnsBSthesia and Ansesthetics — S. A. Billing, M. D., Montgomery. 

5. The Medical Profession in Politics — J. C. LeGband, M. D., 

Birmingham. 

6. Medical and Forensic Importance of Reflexes — W. T. Bcklet, 

M. D., Chicago, 111. 

7. Axis Traction Forceps — J. P. Fubnibs, M. D., Selma. 
Adjournment 

Aftebnoon Session. 

1. Call to order at 3 P. M. 

2. Unfinished Business. 

continuation of VOLUNTEEB PAPEBS. 

3. Pathology of Bums — O. S. Bbown, M. D., Birmingham. 



g fBB MEDICAL ABBOOIATION OF ALABAMA. 

4. Intra-VenouB Saline Infusion — ^J. M. Mason, M. D.» Birming- 
ham. 
6. The Pronated Foot — Michakl Hoke, M. D., Atlanta, Qa. 

6. Pneumonia; Its Occurrence in Pregnant Women; With Re- 

ports of Four Cases — ^J. H. Bdwabds, M. D., Wylam. 

7. Neglected Therapeutic Measures— -W. H. 8Ain>BB8, M. D., Mo- 

bile. 

8. Miscellaneous Business. 
Adjournment. 

BvENiiTO Session. 

1. Call to order at 8 P. M. 

CONTINUATION OF VOLUNTEEB PAFEB8. 

2. Some remarks on the Administration of Anesthetics — B.' B. 

RoGAN, M. D., Selma. 
8. Cocaine Aniesthesia by Lumbar Puncture — S. O. Gay, M. D., 
Selma. 

4. Nephrolithiasis — ^U. J. W. Peters, M. D., Birmingham. 

5. Influenza — ^W. W. HAapEB, M. D., Selma. 
Adjournment. 



FOURTH DAY— APRIL 19. 

1. Call to order at 9 A. M. 

2. Unfinished and Miscellaneous Business. 

3. Report of Board of Censors. 

4. Revision of the Four Rolls. 

(a.) Revision of the Roll of County Societies, 
(b.) Revision of the Roll of Counsellors, 
(c.) Revision of the Roll of Correspondents, 
(d.) Revision of the Roll of Officers. 
6. Election and Installation of Officers. 

6. Unfinished and Miscellaneous Business. 

7. Adjournment sine die. 



THE MEDICAL ASSOCIATION 

OP THE 

STATE OF ALABAMA. 



THE MINUTES OF THE MEETING OF 1901. 



PROCEEDINGS OF THE FIRST DAY. 

Selma^ Tuesday, April 16th. 

The Association was called to order at 12 'M. in the 
hall of the Young Mens' Christian Association by the 
President, Dr. R. M. Cunningham, of Ensley. 

Invocation by Bey. A. J. Dickinson, D. D., of Selma. 

President Cunningham then introduced Dr. W. W. 
Harper, of Selma, who delivered the following address of 
welcome : 

Mr. President and Cfentlemen of the Medical AstodatUm of the State 
of Alahama: 

Today I feel very much Uke a man who has married a widow 
and is being constantly reminded of the superior virtues of the 
late lamented, for, by reference to the programme of exercises it will 
be seen that this address was to have been delivered by Dr. Pitts, 
President of the Dallas County Medical Society. The doctor left 
for a visit to Europe several days ago, and before leaving trans- 
ferred to me the pleasure and honor of extending to you all, on 
behalf of the Dallas County Medical Society, a hearty welcome. 

In this country there is a very delightful custom of holding 
family re-unions. From different parts of the land the children 
come to the family hearthstone, and the old home rings with Joy, 
but with each succeeding meeting there may be a vacant place at 
the fire-side and an unturned plate at the festal board. Selma is 
the old homestead of this Association. Here, as an organised body, 
you were bom, and here is the cradle in which was rocked your 



8 THE MEDICAL ASdOOIAflOIf OP ALABAMA. 

infant form. Tour sires were free from a tuberculous diathesis 
or a carcinomatous cachexia. As a result, your constitution has 
been so strong that it has successfully withstood the macroscopical 
assaults that have been made upon it 

I beseech you to maintain the high standard erected, to resist 
invasion by the streptococcus of discontent, and to clasp hands, 
one with another, and press forward to yet greater achievements. 

The Dallas County Medical Society is honored in being your 
host and takes pleasure in throwing widely open to you the door of 
the parental home and in welcoming you to a place at the family 
fireside. 

While we do not look upon you as returning prodigal sons, we 
will kill the fatted calf and incidentally, I hope, a few spring chick- 
ens. 

But, as I look over this audience, I am pained to note the absence 
of some faces that were often to be seen at these meetings. 

Astronomers tell us that stars are ever and anon silently pass- 
ing out of existence. So is it with the shining lives of the good 
and the brave.. 

Since last we met the life of Dr. John A. McKinnon, who so 
eloquently and touchingly welcomed this Association on the occasion 
of its previous meeting in this city, has faded out, to shine, we 
trust, through all eternity. , 

In the quiet hours of night we stand admiring "the heavens 
which declare the glory of God." The moon has long since pillowed 
her head in rest, and all nature is quietly sleeping, when, suddenly, 
from some celestial disturbance a bright star is snatched from its 
sphere and hurled through space to annihilation, leaving in its 
wake brilliancy and beauty. Such was the tragic ending of the 
beautiful life of our late colleague. Dr. George Chapman, of Bir- 
mingham. 

We welcome you because you have, for the time being, laid aside 
other and important duties and are here in testimony of your de- 
votion to our profession, as well as to renew pledges of loyalty to 
one another and to take counsel as to the best methods of accom- 
plishing the great objects for which you are striving. 

We welcome you as representative men, impressed with the re- 
sponsibilities of your calling, and realizing that precious opportu- 
nities will come to those who are well-equipped for prolonging the 
lives of their fellow men, and thus promoting their happiness. 

We earnestly hope that your deliberations will be of such char- 
acter as shall prove beneficial to every member of this Association, 
and that you may deserve to be reckoned with those who live 



TSE MSaSAGE OF THE PRESIDENT. 9 

"In minds made better by their presence. 

Live in pulses stirred to generosity, 

In deeds of daring rectitude. 

In scorn for miserable aims that end with self. 

In thoughts sublime that pierce the night like stars. 

And urge man's search for vaster issues." 



The President then introduced Mayor A. L. McLeod, 
who in graceful and cordial terms welcomed the Asso- 
ciation to Selma. 

It is to be regretted that a copy of the address could 
not be obtained for insertion here. 

President Cunningham then read his message as fol- 
lows : 

THB MESSAGB OF THB PRESIDENT. 

BussEix McWhorteb Cunningham, M. D., Ensley, Ala.. 

Senior Counsellor M. A. S. A. Ex-President Tri-State Society Ala- 
bama, Georgia, and Tennessee; Ex-President Jefferson Coun- 
ty Medical Society; Member Southern Surgical and Gyneco- 
logical Association. 

Oentlemen of the Medical Association of Alabama : 

The Constitution of the Medical Association makes it 
my duty to "submit to the Association a message, de- 
voted to the discussion of the interests, objects and busi- 
ness of the Association . " These are clearly set forth in 
Sec. 2, Article 3 of the Constitution as follows : 

Sec, 2, Article 3. Objects : "The objects of this As- 
sociation shall be to organize the medical profession 
of the State in the most efficient manner possible. To 
encourage a high standard of medical education, and 
regulate the qualifications of practitioners of medicine 
in the State. To promote professional brotherhood, 
and encourage a high standard of professional ethics. 
To combine the influence of all the medical men in the 
State, so as to secure by legislative enactments their own 
legitimate rights and privileges, and the protection of 
the people against all medical ignorance and dishonesty. 
To encourage the study of the medical b<ytany, medical 
topography, and medical climatology of the State. To se- 



10 THE MEDICAL AaSOOIATIOK OF ALABAMA. 

cure careful and reliable accounts of all the endemic and 
epidemic diseases of the State. In a word, to watch over 
and protect, encourage and aggrandize all the interests 
of the medical profession of the State." 
This section may be succinctly summarized as follows : 

1. To organize the medical profession of the State. 

2. To promote professional fraternity and ethical re- 
lation. 

3. To combine the medical men of the State in a com- 
mon interest. 

4. To encourage a study of local conditions in the 
State relative to the causes of disease. 

5. To study and record the epidemics of diseases that 
may occur in the State . 

6. To raise the standard of medical education. 

7. To protect the people against medical ignorance 
and dishonesty. 

8. To prevent or limit the spread of endemic and 
epidemic diseases in the State. 

9. To prevent the introduction of infectious and con- 
tagious diseases into the State from abroad. 

10. To collect the vital and mortuary statistics of 
the State. 

Of these general objects the first five, to wit, the or- 
ganization of the profession, the promotion of profes- 
sional fraternity and ethics, the co-operation of the medi- 
cal men of the State, the study and discussion of medi- 
cal and scientific subjects, and the study and record of 
endemic and epidemic diseases, are wholly in the hands 
and power of the profession, without the intervention of 
national, state, or municipal laws. 

The last five, to wit, the elevation and maintenance of 
a higher standard of medical education, the protection of 
the people against medical ignorance and dishonesty, the 
prevention of diseases at home, the prevention of the in- 
troduction of infectious and contagious diseases from 
abroad and the collection of vital and mortuary statis- 
tics, are all attainable only through the instrumentality 
of law. 

To procure the first five we have as instrumentalities 
the medical association of the State and the medical 
societies of the several counties thereof. 



THE ME8BAGE OF THE PRESIDENT. H 

To procure the last five, laws have been enacted, to 
wit: 

1. To regulate the practice of medicine by the estab- 
liBhment of examining boards to ascertain the qualifica- 
tions of practitioners of medicine. 

2. To provide for the collection of vital and mortu- 
ary statistics. 

3. To provide for the limitation of some of the infec- 
tious and contagious diseases. 

4. To guard against the introduction of foreign 
diseases by a regulation of quarantine. 

These laws are executed by — 

1. The medical association of the State of Alabama, 
which is the State Board of Health, through its commit- 
tee of public health, to wit, the State Board of Censors, 
whose executive officer is the State Health Officer. 

2. By the several County Medical Societies, which 
are the County Boards of Health, through their com- 
mittees of public health, to-wit, the County Boards of 
Censors, whose executive officers are the County Health 
officers. The terms of office, the incumbents thereof, 
and their duties, are fixed, elected, and prescribed by 
the Medical Association of the State and by the several 
County Medical Societies, respectively. 

The finances are provided by a State appropriation, 
formerly of f3,000.00, now of f4,000.00, subject to the 
order of the State Board of Health, and such sums as 
may be appropriated from time to time by the courts of 
County Commissioners and Boards of Revenue of the sev- 
eral counties. 

The salaries paid are f 1,800.00 to the State Health 
Officer, IfOOO.OO to the clerk of the State Committee of 
Public Health and such salaries as may be fixed for the 
County Health Officers by the Courts of County Commis- 
sioners or Boards of Revenue of the several counties. 

This brief summary of the objects and achievements of 
the medical profession in Alabama, through their State 
and county organizations, should cause every loyal doc- 
.tor's heart to swell with pride; should fire his soul with 
greater aspiration, should stimulate him to still greater 
endeavor, and should cause him to re-consecrate his life 



12 TBB MEDICAL JLSBOCIATIOV OF ALABAMA. 

and work to a better service of God and humanity, for 
such, my colleagues, is the real work of the medical pro- 
fession. Such is the conception, tradition and practice ; 
but not in accordance with any sectarian precept and 
practice, but in the far broader conception of the father- 
hood of Ood and the brotherhood of man, which knows 
no sect, creed, race, nationality or individual, but which 
devotes its endeavors to the relief of suffering wherever 
found. From this lofty, but true conception of the as- 
pirations, ambitions, and objects of the medical profes- 
sion, let us examine the present condition of all these 
questions and problems and see if anything can be 
further accomplished in the achievement of the objects 
of this association. 

ORGANIZATION OP THE PROFESSION. 

Organization and system is the law of God, the law 
of nature, and a human necessitv. Without it there 
could not be a civilization, a government, an institution 
or anything else of an organic nature. Never before in 
the world's history was this truth more generally ac- 
cepted and adopted in the practical affairs of life than at 
the present time. Not only are men and women of a like 
interest uniting their individual efforts, but even inter- 
ests of analogous or allied natures are uniting. Thus 
we have the industrial, agricultural, commercial, com- 
mon carrier, and labor organizations, all striving to bet- 
ter their financial condition. This, wdth them, certainly 
comes first. Whether or not these organizations will be 
for the best interests of society and the world generally 
remains to be seen. The organization of the medical 
profession, on the other hand, is almost wholly, certain- 
ly, primarily, in the interest of the people. The only 
benefit that the individual doctor gets is the indirect 
effect of association. In this way he becomes better 
qualified to practice his profession, and in that way, and 
in that way only is he financially benefitted. No where 
in the Constitution or ordinances of the Medical Asso- 
ciation or of the County Societies is there a vestige of the 
^trades" principle, purpose, or policy. We have no fee 
bills, no black lists, no boycot. On these matters every 



THE MESSAGE OF THE PRESIDENT. 13 

doctor i« a law unto himself. The only regulation we 
have is the ordinance regulating contract practice. 
Therefore, whatever else may be said, nothing can be 
truthfully charged to selfishness or personal gain. Not- 
withstanding these facts, it is the duty of every doctor 
in the State to unite with the legitimate organization of 
his profession. To this end, every legitimate and honor- 
able effort should be made. For any organization to be 
effectual the following conditions are necessary : 

1. It must embrace all those who have a common 
interest. 

2. The special interests of the individual must not 
be fostered by the sacrifice of the interests of the many. 

3. A majority must rule. 

4. Constituted authority must be respected and 
obeyed. 

The organization of the Medical Association of the 
State of Alabama embraces the following classes of mem- 
bers, to wit: 

1. All members of chartered County Medical Socie- 
ties. 

2. Two delegates from each County Medical Society. 

3. One hundred Counsellors. 

4. A limited number of correspondents. 

All these have the right to attend the sessions of the 
Association, to read papers, x>articipate in the discus- 
sions, and have a common right upon the floor. Dele- 
gates and Counsellors alone can vote, and the latter 
only can hold office. Therefore, not more than 232 
votes, all the 66 counties being represented, could be cast 
at one time upon a question. As a matter of fact, how- 
ever, there is never a full representation of all the coun- 
ties, nor are all the counsellors usually present. This 
does not include the Grand Senior life Counsellors 
which is an indefinite number, the number at the last 
session being seventeen. From the statistical reports of 
the several county medical societies reporting last year, 
and published in the Transaction of the Association, it 
appears that there were 1,600 physicians in this State . 
Of these, 930 belonged to the County Societies, 21 were 
honorary members, and 649 were not members of their 
county societies. It may be logically inferred that the 
last number does not embrace all of the doctors not 



14 THE MEDICAL A8800IATI0N OF ALABAMA. 

affiliated with their county societies. From these figures 
we know that only about 58 per cent, of the doctors of 
Alabama are members of their organization. It, there- 
fore, follows that something must be done to bring all 
doctors into professional organization. The Medical 
Association of the State of Alabama and the County 
Societies cannot drive derelict doctors into their organi- 
zation by boycott, professional ostracism or other co- 
ercive method. They must be induced to come in from 
a sense of duty, professional pride, and patriotism, and 
the assurance that the Association and the County So- 
cieties are conducted absolutely fairly and that all have 
equal rights and privileges in determining the policies, 
the methods, etc., and in the election of officers and the 
general conduct of the Association or Societies. In the 
( ounty Society this is the case, but in the State Associa- 
tion it is not the case. It appears to me, therefore, that 
one of the urgent needs of this Association is to enlarge 
its voting membership. This should be done in such a 
way that every physician in the State who is a member of 
a county society, would be eligible to become a member 
of the Medical Association of the State of Alabama. No 
limitation should be placed upon him save that of his 
own free will. To this end I respectfully make the fol- 
lovdng recommendations: 

1. That a member in good standing of any County 
Medical Society in the State may become a member of the 
Medical Association of the State of Alabama with all the 
rights and privileges now allowed delegates, upon the 
payment of an annual fee of five dollars. 

*J. That after being a member and paying dues at the 
rate of five dollars per annum for twenty years, he shall 
become a life member without further payment of dues. 

The above suggestion does not in any way propose to 
abridge the number, the present rights and powers, or 
dignity of the college of Counsellors. Its only purpose 
is to open the door wide to all the profession to all the 
rights and privileges of the Association, so that, if they 
do not enjoy them it is their own fault. The office of 
Counsellor, being elective, is, therefore, one of the dis- 
tinctions conferred by the suflfrages of the members of 
the Association. On the contrary, the collie of Coun- 
sellors should be kept intact, with its present limitation 



THB MSaSAGE OF THE PRESIDENT. 16 

a« to the number, dues, etc. The only modification I 
would suggest is, that the question of locality have noth- 
ing whatever to do with it, but efficiency, professional 
ability, and general excellence alone be the qualifica- 
tions. Let this office be what it should be, but is not, one 
of special distinction. With this estimate and standard 
of the office of Counsellor, there will be few that would 
decline the honor when conferred by the association. It 
would be the ambition of all to attain it. 

SCIENTIFIC FBATUEBS. 

The most important problem of strictly professional 
interest is the reading and discussion of papers. The 
present system of appointing reporters is a good one. To 
get reports upon such subjects as Medical Botany, Topog- 
raphy and Climatology, etc., is next to impossible. Only 
tliose who have been president of the Association know 
the difficulty. I therefore suggest that the Association 
offer a prize of |25.00 for the best paper upon any one 
subject pertaining to Medical Topography or Climatol- 
ogy in this State, as a whole or a defined district. The 
money would be no object, but the honor of success 
would be. 

Papers read before the Association and the discussion 
of the same should be printed in the Transactions. I 
therefore recommend the employment of a stenographer 
to take down and type- write the discussion. 

FRATERNITY AND ETHICS. 

Professional brotherhood has reference to the relation 
of doctors as men. It is felt in the heart, and is ex- 
pressed by friendly greeting and association, and by 
personal kindness, sympathy, and interest. Profes- 
sional Ethics refers to their business relation, and is a 
matter of honor, and is expressed by a fair and honor- 
able conduct towards each other. These rules of con- 
duct, if such are needed, are all laid down in the code 
of Ethics. Doctors whose intentions are good, and who 
have common sense, rarely violate a principle of Ethics, 
even though they have never read them in print. 

Every opportunity to bring doctors closer together so- 
cially and i)ersonally should be embraced. Therefore, 



16 THE MEDICAL ABaOOIATION OF ALABAMA. 

the social features of the State and County Societies 
should be encouraged. It would be a good plan for the 
County Societies to have annual, semi-annual, or quar- 
terly social entertainments as a part of their regular 
work. All these problems are questions for the profes- 
sion itself to solve. With a compact, co-operative, 
united, enthusiastic, and well intentioned profession, 
organized into State and County Societies, there can be 
but one result, to wit, success. 

OBJECTS FOR THE ATTAINMENT OP WHICH LAW IS 

NECESSARY. 

I now call your attention to the objects of this Asso- 
ciation for the attainment of which law and its impar- 
tial execution are necessary. To attain these objects 
the profession by itself, organized or otherwise, is power- 
leg^s. The enactment and execution of the necessary 
laws without the counsel and co-operation of an organ- 
ized medical profession is impossible. Therefore, there 
should be an unbiased, unprejudiced co-operation be- 
tween the profession and the legislative department of 
the State. The medical profession must discover the 
remedy and devise the ways and means of applying it, 
and the law makers must make these operative and effec- 
tive by legislative enactment. The profession must be 
wholly unselfish, and the law makers wholly unbiased. 
Both must recognize their responsibility to Almighty 
(lod and to the people for the way and manner they dis- 
charge their duty, and the motives that inspire them. 
Selfishness and personal interest, prejudice and senti- 
ment must not control either. This is the proper view 
of the relationship between the organized medical pro- 
fession and the law-making power of the State, and 
f) om this standpoint, we will briefly discuss some of the 
problems of legislation. 

1. The standard of medical education, and the pro- 
tection of the people against medical ignorance and dis- 
honesty. 

The present law regulating the practice of medicine in 
this State has revolutionized the whole question of medi- 
cal education and the necessary qualifications to prac- 



THE ME8BAGB OF THE PREBIDENT. 17 

tice medicine. When this law was enacted there were 
only a few colleges of medicine that required a prelimi- 
nary literary education, and still fewer that demanded 
more than two years of attendance for graduation. Now, 
most of the colleges require a fair preliminary education 
as a pre-requisite to matriculation, and every respectable 
medical college in the United States now requires four 
years or four full courses in four separate years to apply 
for the degree of doctor of medicine. The methods of 
teaching have, also, been revolutionized. Most of the 
colleges now have graded courses. The student is not 
only required to fill up the time, but to put in his time 
in hard work. The examinations are strict, exhaustive, 
and elaborate. Not only is the medical student expected 
and required to be well-informed in the principles, but 
also in the practice. To this end clinical teaching in all 
the departments of medicine is an important and essen- 
lial part of the curriculum. Not only is the education 
more thorough, but it is much larger in scope. Micro- 
scopic as well as macroscopic study, the purpose and 
practical use of instruments of precision in the diagnosis 
and treatment of disease, the chemical analysis of solids 
and f uids, the differentiation, classification, cultivation, 
morphology, life history, mode of entrance and exit from 
the body, etc., etc., of bacteria or micro-organisms, and 
many other things are a part of the medical education 
of the day. Not only is there more to teach, but it is 
better taught, and more is required of the student than 
ever before. That the thoroughly educated medical stu- 
dent of the day when he gets his degree is better quali- 
fied to practice his profession than the graduate of 
twenty-five years ago, who has not kept up with the 
profession, is beyond doubt a fact. That all this means 
a higher, yea, verily, verily, a much higher standard of 
medical education than formerly existed, and that the 
people are to a far greater extent protected from medi- 
cal ignorance and imi)osture is self evident to all. 
Gentlemen of the Medical Association, whence comes 
this radical, wonderful, salutary reformation? Was 
it through the voluntary efforts of our medical col- 
leges? Was it through a spontaneous regeneration of 
the medical profession? Was it due to the voluntary 
9 



18 THE MEDICAL A880CIATI0N OF ALABAMA. 

ambition of medical students? No, none of these, the 
reason is to be found in the enactment of laws regulat- 
ing the practice of medicine, and their fair and impar- 
tial execution. Formerly a diploma, that could be 
bought, was the peoples' guarantee of the qualifications 
of doctors. Now it is a diploma that must be merited 
and a medical education that can stand the tests of 
Examining Boards, that guarantee the qualifications. 
Our medical colleges are not mere business institu- 
tions, manufacturing so-called doctors at so much per 
head, but they are necessarily real educational institu- 
tions or otherwise their alumni would be turned down 
by the Examining Boards, and their last state would 
be worse than their first. Who is it that would haul 
down this high ensign of worth and merit? Who is 
it that would degrade the high calling of the physician 
by lowering the standard of his education and quali- 
fications? Who is it that would expose the people to 
medical ignorance and dishonesty, which knows not 
fcheir bodies, their diseases and their treatment, but 
robs them of their substance? To all these there can 
be but one answer, the selfishly interested, and those 
ignorant of the facts, honest, no doubt, but ignorant 
all the same. This selfishness may be found in the 
medical colleges that want students with money, rather 
than students with brains and that prefer a bank ac- 
count to reputation as colleges of learning. Or it may 
be a student of medicine or an unqualified doctor, who 
can not attain the standard for the want of sense, 
means, or application, but who wants to get into the 
pockets of the people. Or it may be some special heal- 
er, divine or otherwise, who has discovered something 
mat nobody besides himself and his clan know any 
thing about; who has a panacea for all the ills of the 
flesh, found only in his "ism," *^athy," or *^ystem," 
but who does not know any thing of the body, its parts, 
structure, tissues, and cells, or any thing of their func- 
tions, or anything of the changes that take place in 
converting normal into abnormal structures, or any- 
thing of the cause effecting these changes, or anything 
of the symptoms and signs which denote the changes, 
or anything of the rational, logical, and practical meth- 



s 



TBE MESBAGB OF THE PRBBIDENT. ^9 

ods of restoring health. Or^ it may 'be some scheming 
politician who wants the influence of some political 
factor in the politics of his district, and who is willing 
to sacrifice what he knows to be the right for the sake 
of this influence. It ivill appear to some that such sel- 
fish interest as this can have no infiuence in repealing 
laws that are against them, or in procuring laws that 
will favor them. Let me say to such that this opinion, 
though sincere and wholly unsophisticated, is not 
founded upon personal observation and facts. In the 
wonderful reformation in medical education in the 
United States, Alabama was a pioneer. Not only so, 
her system is one of the best to be found in the States. 
M^ith vigilance and determination upon the part of the 
profession, these laws are here to stay. Many of the 
people see the necessity for these laws. They under- 
stand their fairness, and know that they protect the 
people largely from medical ignorance and fraud, so 
far as the regular profession is concerned. They have 
not fully realized the importance of requiring all who 
propose to cure diseases, no matter what their method 
may be, to come up to the proper standard of qualifi- 
cation to practice medicine, and some harbor a suspi- 
cion that the present laws regulating the practice of 
medicine are mainly in the interest of the r^ular doc- 
tors, that these doctors, through their examining boards, 
keep out those who are not of their school or who do not 
practice their methods, all of which is grossly erroneous. 
The indications are clear; the people must be shown: 

1. That the regular medical profession is not a 
sect, or school, professing some particular "ism," 
•Apathy," or "system," but that it practices a logical, 
rational art, based upon a practical knowledge of the 
body in health and disease, the causes of disease, the 
changes in the organs and tissues and cells of the body 
in the different diseases, symptoms and signs of 
diseases, their difl'erentiation or diagnosis, their causes, 
terminations, etc., and the use and application of such 
methcKis and means — remedies if you please — ^which 
science and common sense indicate and experience has 
shown to be of the greatest benefit. We draw the line 
at no remedy that is safe and useful, We should teacl^ 



20 ^BE MEDICAL ASSOCIATION OF ALABAMA. 

the people, that medicine is a rational, logical, natural 
Si-ience that must be practiced in a rational, logical, 
natural way to be safe and useful. We should also 
teach them that a system or remedy that is Itself harm- 
less, but which does no good, and which takes the place 
of methods and remedies that are useful and do good, 
is harmful in that it displaces the proper treatment. 
They should be taught to apply the same common sense 
in questions concerning their health, and their restora- 
tion to liealth when diseased, that they do in the every 
day affairs of life. Should a farmer's gin break down 
and some one come and tell him that his gin is not 
broken in any of its parts, that the trouble is only in 
his mind, or that there is really trouble somewhere, but 
that the break could be repaired by rubbing, or by 
prayer, the farmer would very properly regard such 
a person a lunatic, if sincere, or a rascal, if not. Were 
a man drowning, choking, or bleeding to death, and 
were he told that such condition was merely in his 
mind, he would not only properly regard the statement 
as absurd, but would surely lay hold of a rope or rail 
thrown to him, w^ould allow some one to pull the thing 
out that was choking him to death or to check the flow 
of blood. It is just as absurd to say to a man with ty- 
phoid fever, pneumonia, or any other disease, that it is 
all in his mind, or that he can be cured by rubbing or by 
this or that particular remedy. The people should 
learn that the "school" of medicine, the "ism," "pathy," 
"system" that defies common sense, truth, and facts, 
and claims for itself and its followers some special, par- 
ticular, obscure, or secret method or remedy, is an im- 
posture and fraud. The popular idea is that the regu- 
lar medical profession is a particular, defined, and dis- 
tinct school of medicine, having fixed theories, and 
practice, in accordance with some theoretical hypothe- 
sis. Nothing is further from the truth. Hippocrates, 
400 years before Christ, formulated the principles and 
rules which distinguish the regular profession. He 
taught the proper and only reliable method of study — 
that of nature herself, as she works and manifests her- 
self in the bodies of living beings. All sources of light 
should be invoked; any hidden facts, when brought to 



TBB MBSaA&B OP THB PRESWENf. ^l 

lighty muert stand, though they set at naught the '^theo- 
ries," "ism," pathies" of centuries. This is the method 
of the regular profession. 

The facts, whatever they may be, that relate to health 
and disease form the basis of its knowledge. Its the- 
ory is the logical, rational, interpretation of these facts, 
their significance, relation to each other, their cause 
and effect, immediate and remote, their grouping, clas- 
sification, etc., and its practice is the art which seeks 
to apply all these facts to the diagnosis, prognosis, pre- 
vention and treatment of disease. The principles and 
practice of medicine, then, in their broadest and most 
Comprehensive sense may be divided into several dis- 
tinct departments. 

1. Normal Anatomy, or the study of organs, fluids, 
tissues and cells in all their aspects and relations in 
health. 

2. Morbid Anatomy, or the study of organs, fluids, 
tissues and cells in all their aspects and relations in 
disease — disease in general and in particular. 

3. Physiology, or the study of the function or use 
of organs, systems of organs, fluids, tissues, and cells, 
in health. 

4. Etiology, or the study of the causes of diseases, 
remote and immediate, predisposing and exciting. 

5. Symptomatology, or the study of symptoms and 
signs of disease in general and of particular diseases. 

6. Diagnosis, or the naming of the particular 
disease, or differentiation of diseases. 

7. Prognosis, or the study of the termination of 
disease. 

8. Prophylaxis, or the study of the prevention of 
disease . 

9. Treatment, or the study of the cure of disease. 

The classical studies embraced in a general medical 
education, are anatomy, physiology, chemistry, thera- 
peutics or materia medica, principles and practice of 
medicine, surgery, obstetrics, gynecology, hygiene and 
medical jurisprudence. Add to these the special 
study of the diseases of the eye, ear, nose, throat, genito- 
urinary system, the nervous system, including the 
brain, the skin, etc., altogether would make not less 



22 THE MEI^IOAL ASBOOIATlOlf OF ALABAMA. 

than 2O9OOO closely printed octavo pages. These are 
merely the text-books, one on each branch. If we add 
to these a classical text book upon important subdi- 
visions of these studies, we easily have 20,000 more. 
A well selected, properly assorted, medical library, 
will contain not less than 50 books containing at least 
50,000 octavo pages. By these I mean the important 
and essential books containing the essentials of the 
science and art of medicine. 

Such is a brief outline, a mere index as it were, of 
the extent and scope of a medical education. Those 
who desire to practice medicine in a scientific and hon- 
est way, pursue these studies and adopt these methods. 
They jnake up the regular medical profession. They 
are not "Allopaths" or any other sort of "path." They 
claim no exclusive information, secret remedies, or 
hidden skill. They take no occult forces. They ap- 
peal to no unnatural agency. They do not claim to 
have one remedy for all diseases, nor a remedy for every 
disease, nor a single remedy for any disease. Their 
treatment is a rational, logical, common sense applica- 
tion of the best method and the best agencies to aid na- 
ture in the restoration to health. If they have a motto 
at all it is Vis Medicatrix Naturae^ and not Contraria 
Contraris Curantur. 

Knowledge, judgment, skill constitute the triumvi- 
rate that measures the ability and success of the doctor. 
We, therefore, claim that we are entitled to the distinc- 
tion implied in the designation "regular," in contra- 
distinction of the "irregular" or quack. 

Such is the scope of study, the principles and prac- 
tice of the regular medical profession. From the fore- 
going remarks it may be inferred that I have commit- 
ted the medical profession to materialism in the theo- 
logic sense. If such inference is made, I want to dis- 
claim it. It is only in the scientific sense that I have 
thus written. On the contrary, let me emphasize the 
fact that of all men on earth doctors should be con- 
vinced of the existence of a Creator. This conception 
is a logical and scientific necessity to account for the be- 
ginning of the material universe, and the creation of 
natural laws. Let me go further and say that I be- 



THE MEBBAGE OF THE PREBWENT. 23 

lieve, and in this I voice the belief of a majority of the 
medical profession^ that there is a true and living God 
to whom all should look for guidance, help, and bless- 
ing. Let me say further that this same God will not 
hold the man or woman guiltless who allows one of 
His creatures, created in His own image, to die 
through his or her neglect or ignorance. There is no 
greater responsibility to God and man than that which 
inheres in the practice of medicine. 

I hope you will pardon me for the time taken in the 
discussion of this aspect of the problem. To inform 
the x>^ple upon these matters is the most important 
and desirable aspect, and once achieved, the rest is easy 
and solves itself. 

To disabuse the minds of the people that the State 
Medical Association is a trust, monopoly or trades- 
union, whose purpose and object is to keep out of the 
profession the competition of others, and that the act 
regulating the practice of medicine is intended for that 
purpose. 

We know that such is not the object of the Associa- 
tion, and the act does not operate in lessening the com- 
petition. On the contrary, the numerical competition 
is greater than ever and the quality of the competition 
is infinitely better. There are not only more doctors 
than formerly, but very much better doctors. The op- 
portunities of the educated, skilled and experienced 
doctor to display his wisdom and incidentally the ig- 
norance of his competitor are not so numerous as for- 
merly. Mistakes in diagn^osis, prognosis, and treat- 
ment are not as common as they used to be, therefore, 
there are not so many examples of error to demonstrate 
the inferiority of some and the superiority of others. 
While there is still a great deal of difference in the 
ability and skill of doctors, as in all other callings, the 
average is much higher. It, therefore, follows that in- 
stead of the well educated in the medical profession be- 
mg benefitted from the business standpoint by the act 
regulating the practice of medicine, they have been ac- 
tually injured. This is too apparent to require further 
discussion . 

To convince the people that the right to practice 
medicine is not a natural and inherent righti but a 



^4 T^B MSbtOAL AaSOOIATlON OP ALABAMA. 

right to be authorized only upon conditioiiB of quali- 
fications . 

It id strange that any argument should be necessary 
upon this question^ but it is. A stump speaker or a 
l^i<slaitoT 'will proclaim with all the zeal and spirit of 
a persecuted patriot^ that he has the right to employ 
any body he pleases, and that any body that pleases 
has a right to be employed, to treat diseases. This is 
a] ways followed by great applause in the galleries. To 
hear the tale of woes of some of these persecuted lovers 
of liberty, one would think that the act regulating the 
practice of medicine was unique and crtood alone in the 
regulating business, and that it specially, particularly, 
and specifically deprived men of their liberties. Add 
to this the plaintive wail, properly seasoned with tears 
of some disciple, who appeals to have the privilege to 
emiiloy the special "pathist" who can cure him or her, 
generally the latter, after the "allopathist" has treat- 
ed him or her for years^ got all they had, and finally 
turned him or her over to their sad, but inevitable fate 
— death. This is not an over-drawn picture. It ap- 
peals to the natural sense of justice and right of the 
people. And above all, to their sentiment. The other 
side is put to great disiadvantage. The explanation in 
the case of the living witness, there present and testi- 
fying, that there was nothing the matter in the first 
place but some form of functional or inorganic diisorder, 
or error in hygiene that had been corrected, not by the 
treatment, but by the will of the patient only, would 
sound prosaic and inappropriate. Then, again, the 
patients treated by these "ostracised" doctors who were 
really diseased, can not be called from their graves to 
testify. Now what the people want to understand right 
here is this: 

That a pre-requisite to the safe and intelligent prac- 
tice of medicine is a knowledge of disease, and to know 
how to discriminate it. That this knowledge is a 
knowledge of natural facts; that it is constant. That 
pneumonia is pneumonia; that typhoid fever is typhoid 
fever ; that a broken bone is a broken bone, and that the 
facts about all these must be the same, whether treated 
by an osteopath, homeopath, allopath or any other sort 



TSB MSBBAGB OF THE PRB8IDENT. 26 

of a ^^path/' Christian flcientist or any other sort of 
si'ientifit; regardless of any sort of treatment or no 
treatment whatever^ and that the act regarding the 
practice of medicine is intended to apply to all alike^ 
regardless of their system of treatment, and that the 
pai'ticular ^^pathist" who asks to be exempt from the 
act is working for special legislation in his own inter- 
eSii* 

Thai instead of the regular profession asking for 
legislation for the purpose of creating a monopoly, the 
irregulars are asking for legislation to be exempt from 
the operation of the law. That the only class legisla- 
tion asked is asked by the irregulars themselves. All 
who pi of ess to treat disease should be treated alike, 
no matter what their system or method, and to this end 
the law should be amended. The law regulates many 
ether professions and vocations. Lawyers, dentists, 
teachers and others must comply with certain regula- 
tion? before they are allowed to practice their profes- 
sion. How much more important is the regulation of 
that profession which deals with the life and health of 
human beings. 

RECOMMENDATIONS. 

The present method of examination is by the County 
Board of Censors, or by the State Board of Censors. 

A certificate from any of these entitles the holder to 
practice medicine any where in the State. If an appli- 
cant is not passed by the County Board to which he ap- 
plies, he can appeal to the State Board. If the County 
Board does not do its duty and passes an unworthy ap- 
plicant there is no appeal. There is no uniformity in 
the standard fixed by the several County Boards. Some 
are very easy to pass, and others are very hard to pass. 
It therefore follows that applicants frequently go into 
one county to stand their examination and after getting 
their certificate go into another county to practice, 
whose Board they could not have passed. 

What is needed to perfect the law and its applicants 
are the following: 

1. All who propose to cure disease by any method, 
^^stem, or practice whatever should be required to 



26 THE MEDICAL ABSOCIATION OF ALABAMA. 

stand an examination in Anatomy^ Physiology, Path- 
ology. Chemistry, Symptomatology and Diagnosis. If 
the applicant intends to practice general or regular 
medicine he should be required to stand an examina- 
tion also in Practice of Medicine, Surgery, Obstetrics 
and Gynecology. 

2. Those who claim to practice some particular or 
special system or method should be examined as to their 
qualifications to practice their methods, by those fa- 
miliar with the particular method. 

3. The certificate should set forth that the appli- 
cant has passed a satisfactory examination in Anato- 
my, Physiology, Pathology, Chemistry, Symptomatology 
and Diagnosis, and that he has passed a satisfactory 
examination in the treatment of diseases according to 
his school or system. 

4. These examinations should be uniform, impar- 
tial and fair. 

To properly execute such a law a State Board of Ex- 
aminers is necessary. This Board should contain rejh 
resentatives, according to the numerical proportion of 
the so-called schools of medicine. The examinations 
in Anatomy, Physiology, Pathology, Chemistry, Symp- 
tomatology and Diagnosis, should be conducted and 
passed upon and signed by the entire board. The ex- 
amination in the system or method of treatment should 
be conducted, passed upon, and signed by the represen- 
tatives of the particular school the applicant proposes 
to follow — the application for examination to be con- 
fined to the graduates of some school of medicine. 

If the law thus provided, and a State Examining 
Board thus created, the members thereof to be appoint- 
ed by the organizations of the different schools of medi- 
cine, in proportion to the numerical ratio of members, 
the standard of medical education would be greatly 
improved, and the people thoroughly protected from 
medical ignorance and dishonesty, at the hands of the 
irregular as well as the regular practitioners. The 
justice, fairness, and efficiency of the law regulating the 
practice of medicine would be acknowledged by all ex- 
cept the selfish and personally interested, whose oppo- 
sition we can afford to defy. 



THE MESSAGE OF THE PRESIDENT. 27 

I therefore recommend that this Association pass a 
resolution instructing the State Board of Censors to 
endeavor to procure the necessary legislation to affect 
these reforms upon the lines outlined above. 

The prevention and limitation of endemic and epi- 
demic infectious and contagious diseases, domestic and 
foreign. 

Upon no question do the people need more enlighten- 
ment than they do upon the prevention of disease. In 
ract, in all the relations of life prevention in the esti- 
mation of mankind is subordinate to the importance of 
cure. This is so in ethical, sociological, political, and 
all other questions. But it is especially so in the mat- 
ter of disease. Here again the people should learn to 
apply the same principles of common sense that they 
do in their every day affairs of life. 

If the home of the germ is not in this country, then 
it must not be allowed to visit it. Hence the necessity 
for quarantine. If this country is its home, and it pre- 
vails as endemics and epidemics, then every effort to 
stamp it out by local quarantine, isolation and disin- 
fection should be carried out. In a few of these 
diseases medical science is wholly inadequate, for ex- 
ample, La Grippe and Dengue. Most of them, how- 
ever, if the known methods were applied, could be lim- 
ited, checked, and ultimately annihilated. In fact, we 
have one disease, at least, that we can annihilate and 
destroy. That is smallpox. Vaccination renders the 
human body immune, and therefore the smallpox germ 
is harmless. The application of the methods to effect 
these blessings requires community of action, in 
other words, law. Here again we are met with the so- 
called rights of man. Here again it may be said, and 
has been said by intelligent, honest, and sincere men 
upon the floor of the House and Senate of Alabama, 
that this was a free country and that one had the right 
to die of smallpox. It can be said with the same sense 
and better logic, that one has the right to blow out his 
brains. In fact, the latter is far preferable, because 
in that case, no body's brains would suffer but his own, 
but in the first case, while he is exercising his right to 
die of smallpox, he is at the same time killing other 



28 THE MEDICAL A880CIATI0N OF ALABAMA. 

people, who do not want to die of small-pox. The law 
says that a man shall not carry a concealed weapon, 
but it does not prevent him from carrying far more 
deadly weapons, the germs of disease. Typhoid fever, 
diphtheria, scarlet fever, smallpox, tuberculosis, and 
venereal diseases, and possibly malaria could ulti- 
mately be destroyed and wiped off the face of the earth 
by applying religiously, thoroughly, and systematically 
the known methods of preventive medicine. All these 
we have with us in this country. Yellow fever, typhus 
fever, the plague, and leprosy are not diseases of this 
country and they should not be allowed to enter and 
could be effectually prevented by applying the same 
principles and methods in the regulation of quarantine. 
The hope to succeed in all these is Utopian and optimis- 
tic, but they are nevertheless scientifically attainable. 
Therefore, there is no more important work for the 
Association than to procure the enactment of appropri- 
ate legislation regulating all these matters, and in the 
educa4;ion of the people up to the point of action. 

THE COLLECTION OP VITAL AND MORTUARY STATISTICS. 

This has a scientific and commercial aspect; scien- 
tific in that it throws statistical light upon the nature, 
variety, and kind of diseases in the State, the rate of 
increase of the population, etc., commercial, in that it 
enhances the value of property by showing the salubrity 
and good health enjoyed in the State. The law re- 
quires reports upon all these matters, and the doctor, 
as usual, performs his duty in this particular without 
money and without price, even at his own expense for 
postage. 

These things he must do under penalty of the law. 

THE WORK OF THE ASSOCIATION. 

Failure to procure further necessary legislation to 
carry into effect the principles and methods of preven- 
tive medicine, and to further regulate the practice of 
medicine, etc., calls for an explanation. This Asso- 
ciation, last year, instructed its committee on public 
health to prepare certain bills and press them for en- 



THE ME88AQB OF THE PRESIDENT. 29 

aotment into laws. All failed, with one exception, and 
that only succeeded in part. The Association asked 
for an appropriation of $5,000.00, an increase of f2,- 
000.00. The law passed for f4,000.00 or just one-half 
the increase asked. The explanation of this failure is 
to be found in the following facts: 

1. The masses of the people know nothing about 
the question and take no interest whatever in it. 

2. The members of the General Assembly know very 
little about it, and either have not the time or will not 
take the time to study the subject. 

»3. As a political factor in State politics the Medi- 
cal Association of the State is a non-entity, and has no 
[ioteutial influence. 

The indications, therefore, are perfectly clear: 

1. To educate the people up to the proper apprecia- 
tion of the subject and to arouse them into action. 

2. To bring to bear upon the General Assembly 
such influences that will cause them to seriously take 
up these questions and pass upon their merits. 

Now, who is going to do these things? Unless they 
are done, all the resolutions and plans we may adopt 
will get no further than this body. The question is 
squarely up to you, gentlemen of the Association. The 
H'otto of your Association is non-commercial, non-po- 
litical. The ethics of the profession prescribe the pub- 
lic discussion of medical questions. The personal in- 
terests, that is, the financial interests of all of us are 
directly on the other side of the question. When we 
preient disease we kill the goose that laid the golden 
egg. The traditions, customs, and dignity of the pro- 
fession eschew active politics. 

Your whole and exclusive purpose is to benefit the 
public. In one word it is self-sacrifice for the general 
good. 

THE ASSOCIATION CAN ADOPT ONE OP THREE POLICIES. 

1. To rest with what has already been accomplished. 

2. To consider, formulate, and recommend such 
bills as we think necessary, and present them to the 
legislature through the committee of public health and 



30 THE MEDICAL ABBOOIATION OF ALABAMA. 

to press them in an honorable^ quiet^ dignified manner 
as we have done heretofore. 

3. To go into active politics, send missionaries 
among the people to enlighten them, and to bring the 
influence of this organization and its members to bear 
in a concerted and active campaign in the politics of the 
State. 

In discussing these various policies, the ques- 
tion has been asked by some, why should the medical 
profession take any special or particular interest in 
the public health? Where did they get their author- 
ity to act for the public in these matters. Whose com- 
mission do they hold? There can be but one excuse for 
this question, and that is the questioners measure other 
people by their own motives and that a purely patriotic, 
unselfish, and disinterested motive can not exist in this 
day and generation. 

The answer to the question, however, is plain and 
simple : 

1. The information necessary to make effective 
these reforms is wholly technical, that is a part of 
medical, and therefore, a special science. 

A lawyer is no more expected to understand these 
problems than a doctor is to understand the principles 
of law and the rules of its practice. It would be just 
as rational to give a doctor the authority and power 
of a judge, as to give a lawyer the authority and power 
of an official sanitarian. 

2. Doctors as individuals are the medical advisers 
of their clients, both in preventing and curing disease. 
It would therefore follow that doctors as a whole are 
the natural advisers of the community as a whole upon 
these imjwrtant matters. 

3. The very nature of his vocation makes the doc- 
tor, more or less, a philanthropist. This he has been 
taught, it is the traditions of his profession, his paying 
clients expect it, and last, but not least, in the estimate 
of some, his personal interests and professional repu- 
tation require it of him. For these reasons the or- 
ganized medical profession is the natural, rightful, and 
I)roper guardian of the public health. This duty it 
faithfully and fully discharges when it investigates 



THE ME8BAGE OF THE PRESIDENT. 3I 

and discovers the causes of disease, and the method 
of its prevention, and formulates rules and regulations 
necessary to apply them. When these rules and regu- 
lations must assume the force and form of law to be 
effective, the profession discharges its responsibility 
wholly and fully when it tries by honorable, legitimate, 
and dignified means to get them enacted. 

I, therefore, recommend that this Association con- 
tinue the investigation of the causes of disease, the 
methods of their prevention, etc., and to formulate from 
time to time such bills as are necessary to make them 
effective, to present these bills to the General Assem- 
bly of the State, and to give that body all the informa- 
tion we can to aid them in their deliberation and stop 
at that. When w:e do this_we have done our duty. If 
the law makers disregard the advice, then with them 
rests the responsibility. Finally, I would not advise 
the profession as individuals or as an organization to 
go into active politics, to attain these objects. If the 
public can not or will not see the plain facts as they 
are, and if the law makers will not do their duty, the 
me.lical profession should not try to force its counsel 
upon the public, no more than the individual doctor 
does upon his patients. 

There is an aspect of the question, however, that de- 
mands much serious consideration. A great deal has 
been said in this message about the enlightenment and 
education of the people upon all these questions. 

It is no reflection upon their intelligence, or their 
e<iucanon or general culture, to say that they need in- 
formation upon Sanitary and Medical subjects. An- 
other thing, the people when informed usually act, and 
when they do, they act intelligently and honestly. 
Therefore their education in these matters is of great 
importance. The method is difficult to find. 

An address issued by the Committee of Public Health 
friim time to time and published in the newspapers 
would be one way. Newspapers, however, have a 
business department, and they might not see their way 
clear to publish these communications without first 
consulting the business office. The same remarks ap- 
ply to the printing of pamphlets, etc. This Associa- 



32 THB MBDIOAL AB800IATI0N OF ALABAMA. 

tion has no money, and therefore, the business aspect 
of the question makes this method doubtful. 

Another plan might be suggested for the county so- 
cieties to hold annual or semi-annual public meetings 
and then discuss these questions. To this plan are 
ethical objections, and questions of propriety. There 
is one thing, however, about which I have no doubt, 
and that is that the people, once informed, will drive 
from this State every medical imposter, will destroy 
the power and business of fraud and quackery, and 
will provide the necessary laws to protect the people 
from the ravages of preventable disease. The prob- 
lem of instructing the people I leave to you. 

Gentlemen of the Medical Association, your past 
achievement has been great, yea, marvellous. 

The mind that conceived the plan was a master mind; 
the courage that prosecuted it was dauntless ; the states- 
manship and diplomacy that won it, were matchless. 
That mind, courage, and statesmanship are no longer 
available to plan, execute, and achieve, but they still 
live in the hearts of the members of this Association to 
in."^pire them with hope, to encourage them in their 
Avork, and as an example for their methods. 

Jerome Cochran may have a successor, but his equal 
in leadership will not be found. We may perpetuate 
his memory in marble and bronze, but his work for 
humanity and his profession is his lasting, indestruc- 
tible monument. Many of the great men who stood by 
him and aided him in his work have passed away. 0th- 
ei's are passing away. The old regime will soon be 
history. The new must assume its place. Let us not 
falter in the great work before us. 

I Avant to congratulate you on the ability, efficiency, 
and successful administration of your State Health 
Ollicer. His heart is in his work, his mind is active 
and alert, his attention to business constant and effec- 
tive. His great ambition is to serve the State with 
fidelity and faithfulness. In this he is eminently suc- 
cessful. With scant means at his disposal, he has ac- 
complished more in preventing the introduction and 
spread of yellow fever in this State than any health 
ojRlcer in the Gulf States. His integrity is unassail- 



THE MESSAGE OF THE PRESIDENT. 33 

able; his fidelity to his trust unwavering; his loyalty 
unquestionable. The ability necessary to discharge 
the duties of the office^ its actual labors and responsi- 
bility require a great man and at least a fair compen- 
sation should be allowed. The salary is fixed by this 
Association. I therefore earnestly recommend that 
the salary of the State Health Officer be increased to 
S2,400.00 per annum. I desire also to commend the 
faithful work of the Secretary of the Association. His 
duties are responsible and difficult. The time and la- 
bor required are considerable. I therefore earnestly 
recommend that the Secretary's salary be increased 
$100.00 per annum. 

I also recommend that we persevere in the efforts to 
raise the necessary funds to erect a suitable monument 
to the late Dr. Jerome Cochran. 

I also recommend that this Association take an ac- 
tive interest in the American Medical Association. 
This great National Association of American doctors 
should have ail th^ support this Association is capable 
of giving it. 

I desire, also, to commend to this Association the 
Tri-State Aledical Association of Alabama, Georgia, 
and Tennessee. This society is devoted exclusively to 
the leading and discussion of medical i>apers. Its 
meetings are always pleasant and profitable. I hope 
that the doctors of Alabama will attend its meeting, 
and take more interest in it than they have heretofore. 

There are other things to which I would like to call 
your attention but the length of this message forbids. 

With this session of the Association my service as its 
president ceases. I have not done much to further its 
interest. Indeed, the duties of the office, so far as ac- 
tual work is concerned, are not great. I have dis- 
charged them to the best of my ability. I have tried 
to uphold the honor and dignity of the profession by 
my own personal conduct, and have tried to do all I 
could to represent this Association where and when my 
official position called me. 

If I have been unfaithful or remiss, let my good in- 
tention and best endeavors plead for my justification. 
Let me apologize for the length of this message. I 
3 



34 THE MEDICAL AB80CIATI0N OF ALABAMA. 

have said many things more for the education of the 
public than for your own edification. If the conser- 
vative minds of this Association are shocked at the rad- 
ical reforms suggested, let me say to them that they 
are my honest and sincere and matured convictions, 
which I believe are predicated upon the fa^s and logi- 
cal postulates to be derived from history and demon- 
strated by present conditions. To have written other- 
wise than I believe, would be cowardice and hypocrisy 
which would be unworthy of the president of this As- 
sociation. If in your wisdom they are right, adopt 
them; if they are wrong, reject them. Whatever you 
do I know will be done with the proper motive and the 
best intentions, and no doubt will be to the best inter- 
est of this Association and of the people of the State. 

In conclusion let me thank you again for the great 
honor you conferred upon me by electing me your 
president. It is an honor to be a physician ; it is hon- 
orable to be a member of the organization of his pro- 
fession ; it is a distinction to be its president. 

The life work of the doctor is hard, difficult, and 
comparatively unremunerative ; his responsibility is 
the care in health and disease of the earthly tabernacle 
of the human soul; with the conception of the embryo 
his mission begins, officiating at its birth and extend- 
ing through chilhood, youth, adult age and dotage, end- 
ing onlv when the eves are closed in death. For all this 
he gets little of this world's goods, very little more of 
its gratitude and less of its honors. But if work faith- 
fully performed and deeds of charity and benevolence 
count, he will surely have great treasures laid up 
where neither moth nor rust doth corrupt nor thieves 
break through and steal. May we so think, live, and 
act that when the final day comes we may have it said 
of us "well done thou good and faithful servant." 



Under the rules the message was referred to the 
Board of Censors. 

The report of the Senior Vice-President, Dr. S. G. 
Gay, of Selma, was next in order and was presented as 
follows : 



REPORT OF THE SENIOR VICE-PRESIDENT. 35 

REPORT OF THB SENIOR VICE-PRESIDENT. 

Sakuel Gilbebt Gat, M. D., Selma, Ala. 

Senior Counsellor of the Medical Association of the State of 

Alabama. 



Mr. President and Oenttemen of the Medical Association of the 
State of Alabama: 

It is with pleasure that I come before you to present this, my 
third and last report for the Southern division. It is to me a 
source of pride that during my three years of service as vice- 
president I have succeeded in getting some sort of report from 
every county in my district. 

I desire now to thank each one who has in any way 
rendered me assistance * or complied with my requests. Without 
your aid my efforts would have been fruitless. In making this 
report, I have adopted the same classification I used a year ago. 

Class I includes those counties in which the organization and 
work are reported as good. 

Class II includes those counties in which the organization and 
work are reported as fairly good. 

Class III includes those counties in which organization and 
work are reported as unsatisfactory. 

Class IV includes those counties in which the methods are 
loose and irregular, and little or no work is accomplished. 

Under Class I the following counties are enumerated: Barbour, 
20 members; Baldwin, 6; Bullock, 22; Conecuh, 16; Geneva, 18; 
Mobile, 41: Montgomery, 54. Total, 172. The following societies 
have increased in membership during the past year: Barbour, 6; 
Baldwin, 1; Bullock, 5; Conecuh, 1; Geneva, 3; Mobile, 5; Mont- 
gomery, 3. Total, 23. 

The Mobile and Montgomery Societies meet weekly; Bullock 
monthly; Barbour six times a year; Baldwin, Conecuh and Geneva, 
quarterly; with an average attendance of from 25 to 50 per cent, of 
their members. Papers are read and cases of interest reported. 

In these seven counties there are 68 regular physicians not 
members of their respective County Societies. Efforts have 
been made to secure their membership, but without suc- 
cess. Conecuh enjoys the distinction of having all her physicians 
enrolled as members of the County Society. Sixteen students at- 
tend medical colleges from these counties. The number of stu- 



36 THE MEDICAL ASaOOIATION OF ALABAMA, 

(lonts does not include those from Mobile, as the Secretary of that 
Society failed to answer that question. 

Conecuh and Geneva are the only counties in this group where 
students have been examined preparatory to the study of medi- 
cine; Conecuh 2, Geneva 1. Examinations for certificates of quali- 
fication to practice medicine have been held in the following coun- 
ties: Barbour, 2; Bullock, 2; Baldwin, 1; Geneva, 4; Mobile, 6; 
Montgomery, 1. Total, 16. All of the counties in Class I have 
Health Officers whose salaries vary from $100.00 to $600.00 annually. 
All appear to have a fair amount of success in collecting vital and 
mortuary statistics. There would be a great improvement if phy- 
Bii^ians generally would take more interest in this work. 

The Boards of Censors in this group of counties are reported 
as active and attentive to their duties. Barbour, Bullock, Conecuh, 
Geneva and Mobile report Improvement in their work. Baldwin, 
Bullock, Conecuh, Geneva, Mobile, and .Montgomery report the 
sanitary condition of their Jails as good, with ample supplies of 
wholesome food and water. Barbour reports the sanitary condi- 
tion of its jail as poor, with plenty of wholesome food and water. 
Barbour, Bullock, Conecuh, (Geneva, Mobile and Montgomery re- 
port the sanitary condition of their poor-houses as good. Inmates 
are well cared for and plentifully supplied with wholesome food 
and water. Baldwin's poor are cared for by an allowance from 
the County Commissioners. All counties of this group announce 
that their delegates will attend this meeting and present Annual 
Reports. 

Class II is composed of the following counties: Butler, 14 
members; Crenshaw, 14; Dallas, 30; Clarke, 16; Dale, 18; Elmore, 
17; Escambia, 10; Hale, 17; Henry, 25.; Lee, 12; Macon, 11; Sum- 
ter, 15. Total membership, 245. 

Butler, Crenshaw, Dallas, Dale, Lee and Pike endeavor to meet 
monthly, with an average attendance of from 25 to 60 per cent of 
their membership. 

All these counties report that papers are read and interesting 
cases presented and discussed. During the past year the follow- 
ing counties received new members: Clarke 2, Dallas 1, Dale 4, 
Elmore 1, Escambia 1, Hale 4, Henry 2, Lee 2, Macon 2, Marengo 
1, Pike 1, Sumter 4. Total, 25. 

In the following counties there are regular physicians not 
members of the Societies as follows: Butler 1, (his application 
will be acted upon at the next meeting), Crenshaw 2, Clarke 15, 
Dallas 11, Dale 4, Elmore 13, Escambia 4, Hale 4, Henry 10, Lee 4, 
Macon 9, Marengo 14, Pike 10, Russell 4, Sumter 5. Total 110. 



REPORT OF THJS BElflOR VlOEPRESIDEIfT. 37 

All of the Be counties have made efforts to enlarge their mem- 
bership. The following counties have one or more illegal physi- 
cians engaged in practice: Crenshaw 1, Clarke 1, (prosecuted, 
but conviction failed; Dale 1, no step taken to prosecute; Elmore 
Ip prosecuted, convicted, paid fine and agreed to discontinue practice; 
Escambia 1, no effort to enforce the law; Henry 6, no effort to en- 
force the law. Boards of Censors are reported as attentive to 
their duties, but they are certainly negligent in some cases. They 
should at least make an effort to enforce the law regulating practice. 
Marengo has two illegal doctors and Pike one, with the same old story 
of nothing done. Russell one, prosecuted and convicted. Total, 14 
illegal doctors practicing in nine counties with only four of them 
prosecuted. Examinations preliminary to the study of medicine 
have been held as follows: Hale 1, Macon 2, Marengo 1. Total, 4. 
Students are attending medical colleges as follows: From Butler 

1, Crenshaw 1, Dallas 3, Hale 2, Henry 3, Lee 1, Macon 1, Marengo 

2, Russell 3, Sumter 2. Total, 22. 

Examinations for license to practice medicine have been held 
as follows: Clarke 2, Dallas 2, Hale 6, Henry 2, Macon 2, Marengo 
1, Pike 3. ToUl 17. 

All of these counties have Health Officers with annual salaries 
las follows: 

Butler, $100.00. Collects vital and mortuary statistics. 

Dallas, $240.00. Collects statistics. 

Dale $200. Poor success in collecting statistics. 

Elmore, $200.00. Collects statistics. 

Escambia, $150.00. Collects statistics. 

Hale, $160.00. Little success in collecting statistics. 

Henry, $100.00. Moderate success in collecting statistics. 

Lee, no salary, and nothing done in this way. 

Macon, no salary, and no statistics collected. 

Marengo, $100.00. Poor success in collecting statistics. 

Pike, $75.00. Some effort made to collect statistics. 

Russell, $100.00. Fail to collect statistics. 

Sumter, some success in collecting statistics. 

The Boards of Censors in all these counties are reported as 
attentive to their duties. I beg leave to differ with my reporters, 
however, as there are illegal doctors practicing in some of these 
counties and the Boards of Censors make no effort to stop them. 

Elmore, Escambia, Hale, Henry, and Lee report some improve- 
ment during the past year. The following counties report their 
jails in good sanitary condition, with an abundance of wholesome 



38 TBB MEDICAL ASSOCIATION OF ALABAMA. 

food and water: Butler, Crenshaw, Clarke, Dallas, Dale, Escam- 
bia, Hale, Lee, Macon, Marengo, Pike, Russell, and Sumter. 

No report on this subject was received from Blmore and 
Henry. 

The following counties report the sanitary condition and the 
food and water supply of their poor-houses as good: Butler, 
Crenshaw, Dale, Hale, Liee, Macon, Pike, Russell and Sumter. 
Clarke reports the sanitary condition of its poor-house as bad, but 
the food and water supply as good. 

The following counties have no poor-houses, but care for their 
indigent poor by contract through their County Commissioners: 
Dallas, Dale, Escambia and Marengo. Elmore and Henry failed to 
report on this subject. 

All of these counties expect to send annual reports and dele- 
gates to this meeting. 

Class III consists of the following counties, with membership 
as indicated: Autauga 8, ChiKon 7, Coftee 13, Covington 7, Greene 
(not given), Lowndes 20, Monroe 11, Perry 11. Total, 76. The 
Societies of Coftee, Covington and Lowndes endeavor to meet quar- 
terly; those of Chilton, Monroe and Perry, twice a year; Autauga, 
once a year. Until recently Green has had no meeting for sev- 
eral years. The Society is now reorganized and will endeavor ta 
hava regular meetings in future. At the meetings of the Societies 
belonging to this group, there is an average attendance of from 
30 to 60 per cent Papers are read, cases reported, and much in- 
terest is shown. 

The following Societies report increased membership: Autau- 
ga, 1, Coftee 1, Lowndes 1, Perry 2. Total, 6. 

The following Societies report regular physicians in their 
counties who are not members of their respective Societies. Au- 
tauga 6, Chilton 4, Coftee 6, Covington 2, Lowndes 12, Monroe 3, 
Perry 5. Total, 37. Most of these Societies report some eftort 
to induce non-afflliated regular physicians to become members. 

Chilton and Monroe report one illegal doctor practicing in 
each of their counties, and no eftort made to enforce the law. 

Students are reported as attending medical colleges from the 
following counties: Coffee 1, Covington 1, Lowndes 2, Monroe 3, 
Perry 4. Total, 11. 

Examinations for license to practice medicine have been made 
as follows: Autauga 3, Chilton 3, Covington 1, Lowndes 1, Per- 
ry 1. Total, 9. 

The Health Officer of Autauga is paid |50.00. He has little 
success in collecting vital and mortuary statistics. Chilton has 



REPORT OF TRB BBNIOR VlOE-PRSSIDBNT. 39 

no Health Officer, no salary and no statistics. Coffee has a Health 
Officer, no ealary, no statistics. Covington has a Health Officer. 
His salary is $100.00. He has poor success in collecting statisticfl. 
No information on this head has come from Greene. The Health 
Officer of Lowndes receives $26.00. No statistics are collected. 
Monroe pays $100.00. Collection of statistics is unsatisfactory. 
Perry pays nothing and collects no statistics. Autauga, Monroe 
and Perry report their Boards of Censors active in discharge of 
duties. Ti)e other County Societies in this class seem negligent. 
Covington, Greene and Perry are improving somewhat in their 
work. Monroe and Perry report the sanitary condition, food and 
water, of their Jails satisfactory. The other counties in this class 
make indefinite reports, or none. The poor-houses of Chilton, Cof- 
fee and Perry are in good sanitary condition, and food and water 
abundant and wholesome. The poor of Monroe are cared for by 
contract. The other counties in this class are not reported. All 
counties of this group expect to send delegates and reports to thU 
meetiug. 

Class IV includes Choctaw, Washington and Wilcox counties. 
Of these Washington is the only one that reports a meeting during 
the past }ear. The membership is as follows: Choctaw 8, Wash- 
ington 9, Wilcox 28. Total, 43. One new member is reported in 
Washington this year. There are regnilar physicians in each 
coumy who are not members of their Societies. Nothing has been 
dono to secure their membership. Five illegal physicians are re- 
IM)rted in Choctaw. The same county has three students attend- 
ing medical colleges, and Washington has one. 

Choctaw and Washington have Health Officers and Boards of 
Censors, but no effort seems to be made to collect statistics. They 
report tbc sanitary conditions and supplies of their Jails and poor- 
houses as satisfactory. 

On the whole, it is my opinion that there is a general improve- 
mert in the work of the Societies this year, though I have had 
to drop two from Class 1. One other was placed there, however. 
Last year there were ten counties in Class XL This year there are 
fourteen. Last year there were six in Class III. This year there 
are eleven. Last year there were seven counties in Class IV. This 
year there are but three. These figures demonstrate some im- 
provement. I wish to state that this improvement is in no way 
due to my efforts. 

During my first two terms as your Vice-President, I did as 
earnest and conscientious work as any man could do. As a re- 
sult of my experience I recommended to the State Board of Censors 



40 ^^^ HEDiCAL A&BOOtATtOIf 6J^ ALABAMA. 

that tbe AeBociation should provide for the actual expenses of the 
officers to visit delinquent counties and encourage, advise, and in- 
terest thorn in the work. This the Board declined to recommend, 
stating, if I remember correctly, that the honor of holding such a 
position was sufficient compensation for the time, effort, and ex- 
pense incurred in the performance of its duties. The love of hon- 
or, gentlemen, is a noble stimulus to exertion, and no man can more 
readily respond to it than do I. But when it requires the expendi- 
ture of scanty and hard earned dollars to live up to that honor you 
will llnd many of us unable to afford the luxury. I have made an 
eiiperiment which has convinced me that all the writing one can 
do has but little influence toward the upbuilding of County Medi- 
cal Societies. 

Basing my opinion upon personal experience, and prompted 
solely by a desire to further the interests of the Association, I 
ag'iin appeal to the Board of Censors to consider this matter and 
report their decision at this meeting. 



The report of the Junior Vice-President, Dr, W. T. 
Pride, of Madison, waa next in order and was pre- 
sented by him as follows: 

REPORT OP THE JUNIOR VICE-PRESIDENT. 

WnXJAM THOMAS PBIDE, M. D., MADI8017, 

Junior Counsellor of the Medical Association of the State of 

Alabama. 



Mr. President and Gentlemen of the Medical Association of the 

Btate of Alabama: 

At the Mobile meeting of 1899 this Association, to my great 
surprise and pleasure, elected me Junior Counsellor; and last 
year you honored me with the Junior Vice-Presidency. Having 
gone to New Orleans before the adjournment, I did not, of course, 
know who would have the honor of holding this important posi- 
tion, but supposed it would be some one of our distinguished 
members more competent and better fitted in every way than my- 
sel', but upon my return home, being informed of the honor con- 
ferred upon me, I felt inclined to discredit the information, realiz- 
ing how little I merited it. However, I launched out upon this sea 
of trouble, knowing but little of the work, and less of the vexation 
and worry which would fall to my lot. One thing I knew: It 



BEI^ORT OF THE JUNIOR VIOE-PREStDENT. 4I 

took a beginning to make a Bucceseful ending and with this in 
view I set about my task. My first step was to prepare a letter 
which I sent to every practicing physician in my district, 
whether a member of his County Society or not, urging him to 
become an active member of his County Society, and further in- 
sisting on his answering my letter and expressing his views re- 
garding the condition of his Society. This was done in order that 
I might keep in close touch with the doctors in my district. Imag- 
ine my chagrin and astonishment when out of about nine hundred 
such letters, or rather petitions, I received only thirty replies, 
and most of that number were complaints such as: "This man 
ought not to hold this office; and that other fellow is not discharg- 
ing his duty," etc. I will admit this was very discouraging, and 
my efforts might have stopped here; but realizing that success 
may follow failure if effort be often repeated, I set about my task 
^ith renewed energy. Later on, in the summer I prepared a let- 
ter which I sent to each President of a County Society, urging 
him to discharge his duty in every respect, to keep a close watch 
over the Board of Censors, Health Officers, and, in fact, the whole 
Society; to encourage the members, and induce those doctors 
who were not members to become so; and to insist on all becom- 
ing active workers. I further begged him to reply to this letter, 
and freely express his views as to the present condition and future 
welfare of his Society. The same result was obtained, and out of 
the thirty-two counties only four replies came to reward my 
labor. 

When a medical student I was talking one day to a friend 
who had quite a large correspondence. I asked him if he had any 
trouble in getting replies to his inquiries. He replied: "No, never; 
unless I have to write to one of these d — d doctors." I thought 
he was guying me, but now the truth of his remark appeals most 
forcibly; doctors are, beyond a doubt, the most unsatisfactory cor- 
respondents in the world, for the reason that they will not answer 
a plain question. 

I did no more writing until after the first of January, ^hen I 
prepared two letters in which I asked questions as to the condi- 
tion of each Society, addressing one of these letters to each Presi- 
dent and the other to the Secretary. After writing and re-writing, 
and writing again, I have at last had the pleasure of seeing my 
efforts crowned with a limited degree of success. I learn that in 
most of the counties there seems to be some improvement, but 
more especially is this true in the rural districts. The only 
counties not heard from are Blount, Jefferson and Pickens; and 



42 THE MEDICAL ABBOCIATJON OF ALABAMA. 

since they have failed to notify me I am constrained to belioTo 
they have either reached a high state of perfection or else care 
very little for organized medicine. 

The results of my labor I herewith submit In detail, beginning 
with Bibb County and continuing In alphabetical order. 

Bibb County Mkdical Society. — From all Indications this 
county is doing fairly well. The society has a membership of nine- 
teen, and holds quarterly meetings, with an ayerage attendance of 
ten. There are four doctors not members of the society, and one 
Illegal doctor. No active steps have been taken other than to 
threaten him. Dr. J. 8. Moore is Health Officer. His salary is 
one hundred and twenty-five dollars, and he has discharged his 
duty very efficiently. There have been four applicants for the 
practice of medicine, and all received certificates. The Board of 
Censors has discharged Its duty very well, both as a Board of Bx- 
aminers and as a Board of Health. There are two students from 
this county attending lectures. One great obstacle to the growth 
of the society Is the distance some of the doctors have to travel 
to attend the meetings; but regardless of this difficulty the so- 
ciety is doing much better than formerly. 

Blount County Medical Society. — I suppose this County So- 
ciety is still going on in the same old way. Not having heard 
from any of its members, and being unwilling to express an opin- 
ion, lest I might misjudge their progress, I will pass them by after 
expressing the hope that they will awake to their duties. 

Calhoun County Medical Society. — The reporters give a glow- 
ing account of the Interest manifested in this county, and note im- 
provements along nearly all lines. Its condition is most excellent; 
there seems to be no animosity existing among the physicians, 
but, on the contrary, everything is congenial and working in har- 
mony; quarterly meetings were held last year with two extra 
called meetings, at which valuable papers were read and discussed. 
The Board of Censors is reported a little slack and negligent in 
the discharge of its duties, and we hope an improvement can be 
made along this line before the next report. There have been 
three applicants for examination for license to practice medicine, 
and all received certificates. The examinations were held in a 
fair and legitimate manner. Quite an epidemic of smallpox pre- 
vailed during the autumn, during which time one hundred and 
ninety-two cases were reported, one hundred and seventy-two of 
which were colored, and the remaining twenty, white. The means 
adopted for its suppression were vaccination and isolation, which 



REPORT OF THE JUNIOR VICE-PRESIDENT. 43 

proyed most effectual, not a case being reported where the vao- 
cinatlon was successful; the Health OfScer of this county re- 
ported that he had better results from the points than from the 
glycerinised lymph in glass tubes. 

The Health Officer and Board of Censors did not always agree, 
but the former discharged his duty fairly well. His salary 
is two hundred dollars a year. There were a few sporadic 
cases of scarlet fever and diphtheria, but they were isolated and 
suppressed. 

Chkrokeb C!ounty Medical Societt. — ^From the information 
gained, this county seems to be on an average with those of my 
district, holding quarterly meetings, with a membership of sixteen, 
and an overage attendance of eight. Dr. H. L. Appleton of Center 
is Health Officer. His salary is one hundred and fifty dollars. He 
is an energetic and progressive man, and is no doubt exerting every 
effort in the discharge of his duties. There are eleven regular 
practicing physicians in the county not members of the County 
Society, and three illegal doctors, all three of whom have been 
reported to the Qrand Jury; but that body has failed to indict them. 
There were two applicants to be examined for license to practice 
medicine, both of whom received certificates. The Board of Cen- 
sors has been diligent in the discharge of its duties as a Board of 
Eixaminers and Committee of Public Health. There are three 
students from this county taking second and third year courses of 
lectures. An epidemic of smallpox prevailed in the early part of 
last year, but vaccination and isolation succeeded in stamping 
it out 

Clat County Medical Sooiett. — In this county there seems 
to be almost no organization and very little interest manifested. 
This, to a great extent, is caused by the distance the doctors have 
to travel to get to the place of meeting, and also by the condition 
of the roads. The society is supposed to have quarterly meetings, 
but many times not more than one or two members are present 
Dr. Thomas Northen is Health Officer. His salary ranges from 
twenty-five to fifty dollars, being left entirely to the discretion of 
the Commissioners' Court He finds it very difficult to collect 
vital statistics on account of the neglect of physicians to make 
reports. I am sorry to report that my information is that the 
physicians do not conform to the ethical rules which should gov- 
ern the. profession. The Board of Censors has not been punctual 
in the discharge of its duties. There have been two exam- 
inations for license to practice medicine. They were oon- 



44 ^^E MEDICAL ASSOCIATION OF ALABAMA. 

ducted in an Irregular manner, but possibly were fairly done. 

Only one student is reported from this county, and he ia 
taking the third course of lectures. About six or eight cases of 
smallpox have been reported, with one death. Dr. Northen had 
charge of these, and with the assistance of the county authorities 
succeeded in stamping out the disease. It is to be hoped that the 
doctors in this county will now renew their interest in organized 
work, and conduct an active society. 

Clebubne County Medical Society is about keeping abreast 
with the average County Society of the northern district. It has 
a membership of fifteen, and holds quarterly meetings, with an 
average attendance of eight Dr. H. L. Williams, Health Officer, 
receives a very small salary. He succeeded fairly well in getting 
up statistics, but it took a laborious eftort, as the doctors neglected 
to report properly. There are two physicians in the county not 
members of the society, but no illegal doctors. 

There were three applications for examination for the practice 
of medicine, and two received certificates. The other withdrew 
from the examination. The Board of Censors has been fairly 
punctual in holding these examinations, but very slow in return- 
ing the papers. There is one student from this county taking hia 
second course of lectures. No smallpox has has been reported. 

CoLBEBT County Medical Society. — I have heard nothing from 
this county except through my friend. Dr. Rand, who left the 
county early last autumn. I have written several letters to Dr. 
Blair, President of the society and a counsellor; also to Dr. Thomp- 
son, Secretary; but both have utterly ignored my letters. I under- 
stand the society is doing little or no good, and very seldom meets, 
but I hope that through the infiuence of our District Society, known 
as the Tennessee Valley Medical Association, we will get this 
county interested in Society work, and that in the future it will 
prove a great benefit to our State Association. 

CoosA County Medical Society. — This society is doing as well 
as could be expected, considering the distance the doctors have 
to travel to the meetings. While they had only two meetings last 
year, four others were called, but had to adjourn for lack of a 
quorum. They promise to do better next year, and I believe they 
will, for they are expecting a new railroad, and when completed they 
can more easily get to the place of meeting. 

The Health Officer is an active, energetic man, and does fairly 
well collecting statistics. His salary is fifty dollars. 



REPORT OF THE JUNIOR VWE-PRBBIDBNT. 45 

The Board of Censors Is punctual in its work, and has had 
one applicant for examination for license to practice medicine 
These examinations are conducted in a perfectly legitimate man- 
ner. There are two students attending lectures from this county. 

Between one hundred and fifty and one hundred and seventy- 
five cases of smallpox were reported last year, with five deaths. 
Most of the cases were negroes. The disease was promptly sup- 
pressed hy vaccination and isolation. 

CurxMAN County Medical Socikty. — This is one of the fore- 
most societies in the State. While its members are not very num- 
erous, they are good workers, and are steadily growing in numbers. 
They hold monthly meetings, and these are as well attended as 
time and distance will permit. No ill feeling exists in this county, 
and everything works harmoniously. The Health Officer is dis- 
charging his duty, and no complaints are made. The Board of 
Censors has been diligent in the discharge of duty, both as a Board 
of Examiners and Committee of Public Health. There was one ap- 
plication for examination for license to practice medicine, and a 
certificate was granted. Two medical students are reported at- 
tending lectures from this county. No smallpox is reported in 
this county. 

De Kalb County Medical Society is not manifesting the in- 
terest it should, and much less interest was taken in the Society 
work last year than for several years before. I suppose this was 
due to the almost entire destruction of CollinsviUe by fire, that 
town being the most convenient place of meeting. They promise 
to do better in the future. They hold quarterly meetings, but 
these are not very well attended; there is a membership of twelve, 
wi;h an average attendance of six. There are ten physicians not 
members of the Society, but no illegal doctors. Dr. B. P. Nicholson 
is Health Officer, and makes a very efficient one. His salary is 
one hundred and twenty-five dollars. There were two applicants 
for examination for license to practice medicine, and both were 
awarded certificates. The Board of Censors is discharging its 
duty very well. It is punctual enough in holding its examinations, 
but I am informed that the questions are often too elementary, 
while at times they are very unfair. No smallpox is reported. 

Btowah County Medical Society is more backward than it 
should be. Monthly meetings are held. With a membership of 
nineteen, the average attendance is eight. They held ten meet- 
ings last year. Dr. E. T. Camp is Health Officer. His salary is two 



44 ^^E MEDICAL ABSOCIATIOK OF ALABAMA. 

ducted in an Irregular manner, but possibly were fairly done. 

Only one student is reported from this county, and he is 
taking the third course of lectures. About six or eight cases of 
smallpox have been reported, with one death. Dr. Northen had 
charge of these, and with the assistance of the county authorities 
succeeded in stamping out the disease. It is to be hoped that the 
doctors in this county will now renew their interest in organized 
work, and conduct an active society. 

Clebubne County Medical Society is about keeping abreast 
with the average County Society of the northern district. It has 
a membership of fifteen, and holds quarterly meetings, with an 
average attendance of eight. Dr. H. L. Williams, Health Officer, 
receives a very small salary. He succeeded fairly well in getting 
up statistics, but it took a laborious eftort, as the doctors neglected 
to report properly. There are two physicians in the county not 
members of the society, but no illegal doctors. 

There were three applications for examination for the practice 
of medicine, and two received certificates. The other withdrew 
from the examination. The Board of Censors has been fairly 
punctual in holding these examinations, but very slow in return- 
ing the papers. There is one student from this county taking hia 
second course of lectures. No smallpox has has been reported. 

CoLBEBT County Medical Society. — I have heard nothing from 
this county except through my friend. Dr. Rand, who left the 
county early last autumn. I have written several letters to Dr. 
Blair, President of the society and a counsellor; also to Dr. Thomp- 
son, Secretary; but both have utterly ignored my letters. I under^ 
stand the society is doing little or no good, and very seldom meets, 
but I hope that through the infiuence of our District Society, known 
as the Tennessee Valley Medical Association, we will get this 
county interested in Society work, and that in the future it will 
prove a great benefit to our State Association. 

CoosA County Medical Society. — This society is doing as well 
as could be expected, considering the distance the doctors have 
to travel to the meetings. While they had only two meetings last 
year, four others were called, but had to adjourn for lack of a 
quorum. They promise to do better next year, and I believe they 
will, for they are expecting a new railroad, and when completed they 
can more easily get to the place of meeting. 

The Health Officer is an active, energetic man, and does fairly 
well collecting statistics. His salary is fifty dollars. 



REPORT OF THE JUNIOR YWB-PRSBIDENT. 45 

The Board of Censors Is punctual In its work» and lias had 
one applicant for examination for license to practice medicine 
These examinations are conducted in a perfectly legitimate man- 
ner. There are two students attending lectures from this county. 

Between one hundred and fifty and one hundred and seventy- 
five cases of smallpox were reported last year, with five deaths. 
Most of the cases were negroes. The disease was promptly sup- 
pressed by vaccination and isolation. 

CuTXMAN County Medical Society. — This is one of the fore- 
most societies in the State. While its members are not very num- 
erous, they are good workers, and are steadily growing in numbers. 
They hold monthly meetings, and these are as well attended as 
time and distance will permit. No ill feeling exists in this county, 
and everything works harmoniously. The Health Officer is dis- 
charging his duty, and no complaints are made. The Board of 
Censors has been diligent in the discharge of duty, both as a Board 
of Examiners and Committee of Public Health. There was one ap- 
plication for examination for license to practice medicine, and a 
certificate was granted. Two medical students are reported at- 
tending lectures from this county. No smallpox is reported in 
this county. 

De Kalb County Medical Society Is not manifesting the in- 
terest it should, and much less interest was taken in the Society 
work last year than for several years before. I suppose this was 
due to the almost entire destruction of Collinsville by fire, that 
town being the most convenient place of meeting. They promise 
to do better in the future. They hold quarterly meetings, but 
these are not very well attended; there is a membership of twelve, 
with an average attendance of six. There are ten physicians not 
members of the Society, but no illegal doctors. Dr. B. P. Nicholson 
is Health Officer, and makes a very efficient one. His salary is 
one hundred and twenty-five dollars. There were two applicants 
for examination for license to practice medicine, and both were 
awarded certificates. The Board of Censors is discharging its 
duty very well. It is punctual enough In holding its examinations, 
but I am informed that the questions are often too elementary, 
while at times they are very unfair. No smallpox is reported. 

Etowah County Medical Society is more backward than it 
should be. Monthly meetings are held. With a membership of 
nineteen, the average attendance is eight They held ten meet- 
ings last year. Dr. E. T. Camp is Health Officer. His salary is two 



46 THE MEDICAL ASSOCIATION OF ALABAMA. 

hundred dollars. He is meeting with good succeBS. There are 
twelve doctors not members of the society, but there are no illegal 
doctors, and no applicants for examination for license to practice 
medicine. Two students attend lectures from this county, taking 
second and third courses. The Board of Censors has been punctual 
in its duties. This county has had smallpox, but I could not learn 
its extent nor how it was managed. 

Fatettb County Medical Society is in excellent working 
order and is an example worthy of emulation. The membership is 
eleven, and only one regular doctor is not a member. Also one 
Eclectic. There are no illegal doctors. They have regular quar- 
terly meetings, at which papers are read and cases reported and 
discussed. There is also an occasional called meeting. There 
were five meetings last year, with an average attendance of six. 

Dr. R. M. Seay is Health Officer. His salary is one hundred dol- 
lars. He is an energetic worker and succeeds fairly well in col- 
lecting vital and mortuary statistics. There were three applicants 
for certificates to practice medicine, and all were successful. 

The Board is punctual in its work, and tries to give fair ex- 
aminations. There are four medical students from this county, 
all of whom are second year men. La grippe was quite prevalent 
there last spring and caused a number of deaths. Malarial fevers 
were worse than known in years; supposed to be on account of the 
excessive rains and heat. There was quite an epidemic of scarlet 
fever, but this is now under control. Smallpox developed in sev- 
eral places in the county, but by prompt action on the part of the 
medical and county authorities, they have been able to control it 
Whenever the authorities have assumed control the spread of the 
disease has ceased abruptly. The infection came from outside 
counties. 

Franklin County Medical Society has a membership of six- 
teen, and is supposed to hold monthly meetings, although they are 
very irregular and have a very small attendance, from lack of in- 
terest. There have been four examinations for license to practice 
medicine, and at the time of my information one applicant had 
received a certificate, one was standing his examination, and the 
other two, after making application, had not come up. My re- 
porter was afraid that they would not appear, but were practicing 
without license. The Board of Censors is very slack in the per- 
formance of its duties, and too often slow in propounding the 
questions and holding the examinations. Dr. J. K. 
Clarke is Health Officer. His salary is seventy-five dollars a year. 



REPORT OF THE JUNIOR YWE-PRESIDENT. 47 

I do not know how he is discharging his duty. This county had 
ahout twenty-five cases of smallpox last spring, but It was stamped 
out by vaccination and isolation. 

Jackson County Medical Societt has a membership of ten. 
The society met monthly until this year, but only meets quarterly 
now. Four meetings were held last year. An unusual amount of 
sickness, together with the long distance to travel, were the causes 
of so few meetings. The average attendance was six. Dr. J. W. 
Knowlton is County Health Officer, and receives a salary of one 
hundred and fifty dollars. He is an energetic, competent man, 
and succeeds well in collecting vital statistics. There are twenty- 
five regular practicing physicians in the county, and I am sorry 
to say two or three illegal doctors. The society has often tried to 
stop these law-breakers, but the officers and Juries fail to punish 
them. Five applicants were examined for practice of medicine in 
1900, of whom three passed and two failed. The Board of Cen- 
sors is punctual in holding meetings and grading examination 
papers, and gives fair, practical questions. One young man from 
this county is studying medicine, and is on his third course. The 
prevailing disease last year was malarial fever of different types, 
with an unusually large number of cases of pneumonia frem Jan- 
uary to April. 

Jefferson County Medical Society is, I suppose, the banner 
county of the State, with a membership larger than any other 
three counties combined; but they have either been too much en- 
grossed with their own affairs to notice my letters, or else they 
were swept away in the storm. I rather apprehend the latter ca- 
lamity, for I believe nothing else could have deterred our honored 
President from giving us some insight into their condition. I 
have written in all about two hundred letters to this county at an 
expense of about five dollars, but have failed utterly to receive a 
singlOf reply. I trust, however, this society is accomplishing much 
good. 

Lamab County Medical Society is in the same old rut. There 
is no improvement, and it seems there never will be; for the doc- 
tors do not work in unison. They will not attend their Society, 
and seem to care very little for organized medicine. Dr. W. F. 
Elliott is Health Officer, and has a very hard time getting the 
vital and mortuary statistics. No smallpox or epidemic diseases 
are reported. There have been four examinations for license 
to practice medicine and all the applicants received certificates. 



48 THE MEDICAL A8800IATI0N OF ALABAMA. 

The Board of Censors Is doing only fairly well. We hope the 
doctors of Lamar will some day awaken to the duties of the loyal 
physician. I have received later information from Drs. HoUis and 
Kennedy to the effect that the condition of Lamar county is less 
unfavorable than at first reported. 

Lauderdale Ck)UNTY Medical Society seems to be one of the 
lagging societies in the northern district. It is about time we 
were having a revival there and I hope to hear of it very soon. 
The Health Officer is doing very little good, and seems to have 
crossed swords with the Censors. There have been no appli- 
cants for examination for license to practice medicine. The Board 
of Censors is doing little or no good. They have had about thirty 
cases of smallpox, but I am not informed how the disease was treated. 
One medical student attends lectures from this county. 

Lawrence County Medical Society has a membership of fif- 
teen, and usually holds quarterly meetings. They had only two 
meetings last year, however, because the doctors took so little 
interest; the average attendance is six. Dr. Willam I. McMahon 
is Health Officer. His salary is one hundred dollars. He labors 
under great difficulties, for he cannot get the doctors to report. 
All the regular physicians are members of the Society, and there 
are but two illegal doctors, one of whom was prosecuted, but he 
was not convicted. The Board of Censors does very good work. 
There are two medical students from this county. Five cases of 
smallpox were reported, but it was held in check by vaccination 
and isolation. 

Limestone County Medical Society has always been an enig- 
ma. While they have some excellent men, they seem to take 
very little interest, and it has been impossible for me to get a cor- 
rect report, although I made an earnest effort. I suppose my in- 
formant mistook me for the Secretary of the State Association, as 
he sent me a revision of the roll, which I handed to the Secretary, 
but no dues accompanied said roll. This Society does not meet 
oftener than once in two years, and then only three or four are 
present out of a membership of fifteen. There is one illegal doc- 
tor, but no steps have been taken to prosecute him. The reporter 
mentions one application for examination for license to practice 
medicine, and five medical students from this county. Dr. N. D. Rich- 
ardson is Health Officer. His salary is one hundred and twenty- 
dollars. Limestone has had quite an epidemic of smallpox in 
the eastern part of the county. Nothing was done to check it until 



REPORT OF THE JUNIOR YIOB-PRESIDENT. 49 

it spread so rapidly that it was nearly beyond control. After a 
while the authorities took charge and vaccinated most of those 
who had escaped. Nearly all the cases, however, were among 
the negroes. 

Madison County Medical SocnrrY is in better condition than 
any other County Society I have heard from in my district It has 
had twelve regular meetings, with twenty-nine members in good 
standing, and with an average attendance of twelve. The mem- 
bers take great interest in the Society and have a paper at nearly 
every meeting, which is fully discussed; they also report many 
cases of interest to the profession. This Society, at a called meet- 
ing in December, 1900, organized the Tennessee Valley Medical 
Association with a membership of forty. It was the intention of 
this Association to visit different counties in this district for the 
puri>o&e of getting up enthusiasm among the doctors, thereby 
building up the County Societies. The Board of Censors has ex- 
amined four applicants for license to practice medicine. This 
board is very active in looking up the illegal doctors and giving 
notice to them to appear before the Board. They have been very 
diligent in looking after smallpox, though they had considerable 
trouble with the County Commissioners in getting control of mat- 
ters. This Board tenders its thanks to our efficient State Health 
Officer for services rendered during the controversy with the Com- 
missioners. Dr. W. C. Wheeler is Health Officer. His salary is 
two hundred dollars, and he is doing excellent work. There are 
twenty-three doctors in this county not members of the Society, 
but there are no illegal doctors. There are two medical students 
from this county. This county has been infested with Osteopaths 
lately, but two of them have departed to parts unknown; how- 
ever, we still have a school of Magnetic Healers and Osteopaths 
combined. 

Mabion County Medical Society has a good organization with 
a membership of fourteen. Quarterly meetings are held, with an 
average attendance of nine. A committee waited on the County 
Commissioners, but failed to secure a salary for Dr. J. R. Burleson, 
the Health Officer. He has not collected the vital statistics; it 
seems he failed to apply for blanks. There is only one illegal doc- 
tor, and he has been reported, but to no effect There were two 
applicants for examination for license to practice medicine, and 
both received certificates. Also one certificate was granted to 
Dr. J. H. Stone, who lives in Mississippi, without examination, 
for the reason that he had just received one from the Mississippi 

4 



50 THB MEDICAL JiSaOOIATION OF ALABAMA. 

Board. The Board of Censors Is very punctual. Five medical stu- 
dents are reported from this county. 

Mabshall County Medical Socncrr has made no improvement 
since last year. Some of the doctors try to hold regular meetings, 
hut the others will not attend; as they have so often heen disap- 
pointed by not having enough present to hold a meeting. Dr. S. 
M. Elrod is Health Officer. His salary is forty dollars. It is to be 
feared that he neglects his duty, as his report is incomplete. There 
were eight applicants for examination for license to practice medi- 
cine, and all received certificates. The Board of Censors is very 
lax in the discharge of its duties. Some of the members are slow, 
and leave all the work to the others; and as a Committee of Pub- 
lic Health they amount to nothing. Three medical students from 
this county are taking their third course of lectures. There was 
some smallpox last winter, but it was kept under control. 

MoBGAN County Medical Society is also on the decline. It 
meets about once a year. Other meetings are sometimes called, 
but the doctors do not attend. Dr. S. L. Rountree is Health Officer, 
but I am uninformed as to his success. There were four appli- 
cants for examination for license to practice medicine reported, all 
of whom received certificates. I could hear nothing from the Board 
of Censors. Decatur, a thriving town, is located in Morgan County, 
and there is no reason why they should not have a fiourishing 
Society at that place, as it contains some most excellent men. 

Pickens County Medical Society has not yet been heard 
from, but having much confidence in the old adage "still water 
runs deep," I am sure it is fiourishing. 

Randolph County Medical Society. — ^There is a lack of inter- 
est among the doctors of this county but judging from my infor- 
mation we can hope for some improvement, and perhaps for a live 
Society. They have a membership of twenty-one, and hold quar- 
terly meetings; five meetings were held last year with an average 
attendance of ten. Dr. O. P. Trent, Jr., is Health Officer, and is 
a young man of push and energy. He will no doubt make an ef- 
fort to do his duty. His salary is only seventy-five dollars. There 
are two regular physicians In the county who are not members 
of the Society; illegal doctors are a thing of the past Have had 
only one applicant for examination for license to practice medi- 
cine and the Certificate was refused. The Board of Censors is 
doing its full duty and should be an example for others. Two stu- 
dents from this county attending lectures. 

Shelby County Medical Society. — ^From all indications this 
Society is f^ above the average of the district. It la doing good 



REPORT OF THE JUNIOR VICE-PRESIDENT. 51 

work and making steady improyement. It has a membership of 
sixteen and holds monthly meetings; eight very interesting meet- 
ings were held last year. There are seven doctors who are not 
members of the Society In the county. Dr. J. H. Gunn is Health 
Officer. His salary is one hunlred and fifty dollars. He has had 
good success and is in every way a model officer. There were 
three applicants for examination for license to practice medicine. 
Two received certificates and one was rejected. The Board of 
Censors is up to date, discharging its duties punctually. There 
are four students of medicine from this county. Some smallpox 
has appeared but was soon checked by the Health Officer. 

St. Claib Countt Medical Socixtt is in better condition than 
it has been for the past ten years. The doctors are taking more 
interest; it has eighteen members with an average attendance of 
from eight to ten, while there are only three non-members in the 
county and these promise to Join at the next meeting. Their 
meetings are quarterly, though they only held two meetings last 
year. The weather was so disagreeable the other times that the 
doctors could not attend. A brotherly feeling prevails through- 
out the county and every thing works smoothly. Dr. J. W. Ash 
is Health Officer, with no salary. He is having excellent success, 
considering the circumstances. When the doctors do not report 
he returns them to the Grand Jury. They have no illegal doc- 
tors. The Board of Censors is giving perfect satisfaction. Only, 
one applicant for license to practice medicine has appeared and 
he was granted a certificate. There are two medical students 
from this county. Forty or fifty cases of smallpox were reported 
last year, but the disease was soon stamped- out by an earnest 
effort on the part of the Health Officer. 

Talladega County Medical Societt is characterized by a 
spirit of good fellowship and a great degree of scientific interest. 
It had an annual banquet in January, at which time sorrows and 
disappointments were drowned in revelry and feasting. It has a 
membership of twenty-seven, with an average attendance of seven- 
teen. Dr. W. G. Harrison is Health Officer. His salary is three 
hundred dollars, but he is required to treat paupers isolated in the 
pest house. He has had moderately good success. There are two 
men in the county claiming to possess and use specific applications 
for the relief of cancers and tumors; one of these was prosecuted 
but was not convicted. The Board of Censors is discharging its 
full duty. One student from the county is attending the first 
course of lectures. There has been ten or twelve cases of small- 
pox but It was not allowed to spread. 



52 THE MEDICAL ABBOCIATIOV OF ALABAMA. 

Tallapoosa Couittt Medical Soctbtt has a membenhlp of 
twenty-four, three haying Joined recently. It has always met 
quarterly until last year, when there were only two meetings, with 
an average attendance of twelve. In January of this year they 
held a very enthusiastic meeting and elected new officers, and 
hope to do much hotter in the future. Dr. A. L. Harlan is Health 
Officer. His salary Is one hundred and fifty dollars. The doctor 
has been Health Officer for the past five years and has had very 
good success in collecting statistics and promptly suppressing 
diseases. There are only five practicing physicians in the county 
not members of the Society, and three of these have made appli- 
cation for membership. There are no illegal doctors. They had 
one last year but a true bill was sufficient to get rid of him. The 
Board of Censors has not been as prompt as it should be In the 
discharge of its duties, but is composed of competent men and 
will do better in the future. One student from the county is bXt 
tending his third course of lectures. There was an outbreak of 
smallpox at Alexander City, but it was limited to negroes and was 
soon checked. They have had sporadic cases of scarlet fever In 
the western part of the county for more than three years, and 
have also had an epidemic of measles and whooping-cough with 
other usual diseases. 

Tuscaloosa Countt Medical Socdbtt is in a favorable condi- 
tion. The members manifest considerable interest in building up 
the Society and raising the medical standard of the county. It 
has a membership of nineteen and now meets twice a month, on 
the first and second Mondays; six meetings were held last year 
with an average attendance of seven. Dr. R. Neilson Is Health 
Officer. His salary is twenty dollars per month. He has been 
very successful in collecting vital statistics and makes an excel- 
lent officer. There are fifteen physicians in the county not mem- 
bers of the County Society, and two illegal doctors. The Society 
has taken action to prosecute them. There were three applicants 
for examination for license to practice medicine, and all received 
certificates. Some of the members of the Board of Censors have 
not been as punctual in holding the examinations and grading 
papers as they should be. There are four medical students from 
this county. There have been quite a number of cases of small- 
pox throughout the county, but it seems they have it under con- 
trol. 

Walker Couittt Medical Socibtt has a membership of nine- 
teen, with seven doctors not members. Their rule la to hold 



REPOHT OF fM]& JVmon VtOB'PREBtbBNt. 53 

monthly meetings, though often they fail to have a quorum, and 
last year only three meetings were held, with an average attend- 
ance of seven. Dr. A. M. Stovall is Health Officer. His salary is 
three hundred dollars. He has had good success. Two illegal doc- 
tors are reported, one of whom was prosecuted and left the county; 
the other will be returned to the next Grand Jury. Only one appli- 
cant for examination for license to practice medicine is reported 
and his papers have not been returned. The Board of Censors 
is doing fairly well. Five medical students from this 
county are reported, and about ninety cases of smallpox. 

Wu^sTOK County Medical Society. — ^There is no improvement 
in this Society. Quarterly meetings are held, with very good at- 
tendance. The Health Officer tries to discharge his duty, as does 
also the Board of Censors. There were four applicants for exami- 
nation for license to practice medicine and all received certificates. 
There are three medical students from this county taking their 
first course of lectures. There are no illegal doctors in this coun- 
ty. They had a few cases of smallpox but it received no atten- 
tion. We hope for a general revival of interest very soon. 

In these thirty-two counties there are nine hundred and fifty 
regular practicing physicians, five hundred and eighty of whom 
are members of the Medical Societies of their respective counties; 
while three hundred and seventy are not thus affiliated. In other 
words thirty-nine per cent of the medical profession in my dis- 
trict take no interest in the great medical and sanitary work which 
this Association and the County Societies have instituted. This 
is a condition that by no means speaks well for the profession 
and we should go to work to secure the co-operation of these gen- 
tlemen. It is most necessary and desirable. If we could present 
a solid phalanx against the quacks who are invading us from all 
sides, such would prove a formidable barrier against further 
encroachment and would aid greatly in the intellectual and moral 
advancement of the medical profession. 

In this district sixteen men are practicing without license. 
In most cases, some steps have been taken against them but in 
the majority of instances the proper eftort was not made, and we all 
know this should not be so. Fifty medical students have been re- 
ported. Sixty-four applications for examination for license to 
practice medicine were made, and of this number only four appli- 
cants were rejected. This was either an exceptional body of ap- 
plicants or else some one failed to discharge his duty. Right here, 
if the Association will excuse me, I will suggest that we have a 



g4 TtiB MBDtCAL AaBOOlATION OF ALABAMA. 

standard, or at least some definite requirements; for while some 
counties are strict enough, giving equitable and proper questions^ 
others are too lax, the questions being irregular and too elemen* 
tary. It is a disgrace to the profession that certificates are some- 
times given when not deserved, and to men who are incompetent to 
practice medicine. 

No longer ago than last year one of these quacks came to our 
county and set up his shop. The Secretary of the Board of Cen- 
sors waited on him to see by what authority he was practicing. 
He referred us to the records, and to our surprise we found a cer- 
tificate issued by the Board of Censors of one of the other coun- 
ties of the State. 

Another instance will serve to illustrate the need of a stand 
ard. An applicant was rejected in Jefferson County last spring. 
He moved to a county in the northern part of the State, stood an 
examination and practiced for about six weeks, and then returned 
to Jefferson a full fledged physician. Upon investigation I find 
some of the counties have a certain definite and specific lot of 
questions that they have given for a number of years. These are 
widely circulated and of course it is no trouble for an applicant to 
pass the examination after securing these. Such little incidents 
serve to show us our needs as well as why we are so far below 
the standard. It is our duty to rectify this evil and I would sug- 
gest as a relief that the applicant make application to the Board 
of Censors and stand his examinations as formerly. Then let the 
papers be sent to the State Board and give it the power to re 
gradb if graded too low or too high; and if unfair questions are 
asked pr if those asked are too elementary let the State Board 
order the Board of Censors to regrade or re-examine the appli- 
cant as it sees fit 



The report of the Secretary, Dr. G. P. Waller, of 
Montgomery, was next called for. 

Dr. W. H. Sanders stated that he had been informed 
that a train on which the Secretary should have ar- 
rived before this time was greatly delayed, and moved 
that on account of the absence of the Secretary the 
hearing of the report be postponed ; but that after hav- 
ing been rendered it shall apjyear in its usual place in 
the. published volume of Transactions. The motion 
was adopted. 



KBPOltt OP THMI BEORSTAJtt. gg 

SBGRBTARY'S RBFORT 1901. 

Owing to the long and desperate lllneas of my mother, who is 
nearing the end of her 74th year, and having to occupy two posi- 
tions (that of an only son, and of physician in charge of the case), 
and having to take her to New York and not being able to get 
home until the night of April 12th, I am compelled to submit to the 
AjBScoiation what might be termed a "Skeleton Report." In it I 
will state only facts and these as succintly and briefly as possible. 
I will revise the report before publication and submit it to Dr. San- 
ders for approval. 

The work of the Secretary is increasing every year and more 
of his time is being demanded and the position of Secretary is by 
no means a sinecure. 

In 1898, when I succeeded Dr. Jordan as Secretary, the Secre- 
tary had to send out blank reports to 66 county societies and send 
an annual circular to the 1,100 members of the Association. 

That year it was required of the Secretary to still send the 
circulars and also a program to each member of the County So- 
cieties. At the meeting held in Montgomery, 1900, a resolution 
was adopted instructing the Secretary to have printed in pamphlet 
form the report of the Board of Censors, and mail a copy to each 
physician in the State. 

A resolution was also adopted that the Secretary should also 
have a label printed to be pasted on the back of Transactions of 
1898, stating that this volume contained Perry's Index. Since the 
meeting of 1900, the Secretary has directed and mailed: — 

2,300 copies of report of Board of Health. 

1,200 Annual Circulars. 

1,300 Programs. 

66 Blanks for County Reports. 



6,866. 

We also had a thousand labels printed and put one on each 
volume of Transactions sent to members. 

Early. in March he made arrangements with the Southeastern 
Passenger Association for the usual rates, full fare to Selma and 
1-3 fare return, if certificate is signed by Secretary. 

The average correspondence of this office is from 2 to 6 letters 
dally. 

Put correspondence at 1,000 letters. 



gg fElB MEDICAL ABaOOtSTtOlf OF ALABAMA. 

Circulars, reports and programe, 6,000. In all 7,000 which 
the Secretary will have to direct and mail. This la an enormooB 
task and takes a great deal of time. 

The Secretary is also Chairman of the Publishing Committee 
and has to prepare all the copy for the printer, read and correct 
all the proof (except report of Board of Censors, which State 
Health Officer, W. H. Sanders, M. D., prepares and reads and cor- 
rects proof of the Report of Board of Censors) and also corrected 
and revised all papers that were published in Transactions of 1900. 
This is an immense job and takes a great deal of time. It was a 
big relief to the Secretary. 

The reports from the County Societies have been very slow 
in coming in and the inclination to put it off till the last minute 
seems to be increasing. Owing to my absence from the city and 
the accumulation of clerical work in my office, I have paid the 
sum of $12.60 for clerical assistance. I ask the Association to 
allow this claim. 

In making my preparations on Monday night, I found that 
the old canvass box which contained the records of the Associa- 
tion, was in too bad a condition to be used, as I do not think it 
would carry the books safely. Not having time to make other 
arrangements, I left these records. These books are writen nearly 
up to date and the record will be completed before June Zst. 

Badges for this meeting were also bought and are in the hands 
of Dr. Perry for distribution. Respectfully, 

G. P. Walleb^ M. D., 

Secretary. 



The report of the Treasurer, Dr. H. G. Perry, of 
Greensboro, was next in order, and was submitted as 
follows : 

REPORT OP THE TREASURER. 

Henry Gaither Perry, M. D., Treasurer, in account with the 
Medical Association of the State of Alabama, from April 17th, 1900, 
to April 16th, 1901. 

Receivicd from Grand Senior Counsellors. 

Baldwin, B. J I 10 00 

Bragg, Shirley 10 00 

Brockway, D. S 10 00 

Cason, D. E 10 00 



REPORT OF THE TREASURER. 57 

Dewees. T. P 10 00 

Fletcher, R. M 10 00 

Franklin, C. H 10 00 

Goggans, J. A 10 00 

Goode, Rhett 10 00 

Gk>odwln, J. A 10 00 

Harlan, J. J 10 00 

Hill, L. L 10 00 

Huggins, J 10 00 

Inge, H. T 10 00 

Jay, Andrew 10 00 

Jones, C. C 10 00 

Kendrick, J. C 10 00 

Legrand, J. C 10 00 

Lowry, S. H 10 00 

Mar^chal, E. L 10 00 

Nolen, A. J 10 00 

Redden, R. J 10 00 

Robertson, T. L 10 00 

Searcy, J. T 10 00 

Shell, B. H 10 00 

Sledge, W. H 10 00 

Stovall, A. M 10 00 

Thetford, W. F 10 00 

Trent, P. G 10 00 

Whaley, Louis 10 00 

Wheeler W. C 10 00 

Wilkerson, W. M 10 00 

Wilkerson, C. A 10 00 

Total Number, 33. Total amount |380 00 

Received fbou Seniob Ck>nNSELL0BS. 

Andrews, Glenn 110 00 

Bell, W. H 10 00 

Blake, W. H'. 10 00 

Bondurant, B. D 10 00 

Brown, Geo. S 10 00 

Cameron, M. B 10 00 

Coley, A. J 10 00 

Cunningham, R. M 10 00 

Davis, W. E. B 10 00 

Despres, L. W 10 00 



58 THE MEDICAL ASSOOtATION OF ALABAMA. 

Duggar, R. H 10 00 

Frazer, T. H 10 00 

Gay, S. G 10 00 

Harper, R. F 10 00 

Heflln, Wyatt 10 00 

Hill, G. A 10 00 

Hunter, H. M 10 00 

Howie. J. A 10 00 

Johnston, L. W 10 00 

King, Goldsby 10 00 

McCants, R. B 10 00 

McLaughlin, J. M 10 00 

Moody, H. A 10 00 

Moon, W. H 10 00 

Parke, T. D 10 00 

Perry, H. G 10 00 

Quln, W. B 10 00 

Rlggs, E. P 10 00 

Sutton, R. L 10 00 

Swan, J. C 10 00 

Williams, J. H 10 00 

Watklns. I. L 10 00 

Whitfield, B. W 10 00 

Wilkinson, J. B 10 00 

Total No. 34. Total paid $340 00 

Received fboh Juniob Counssllobs. 

Bancroft, J. D 110 00 

Brannon, H. L , 10 00 

Bennett, B. F 10 00 

Dixon, J 10 00 

Dryer, T. B 10 OO 

Gaston, J. L 10 00 

Guice, C. L 10 00 

Graham, W. A 10 00 

Harlan, A. L 10 00 

Harrison, W. G 10 00 

Henderson, S. C 10 00 

Henley, A. T 10 00 

Hill, R. S 10 00 

Jones, Julius 10 00 

Jones, B. 8 10 00 



REPORT OF TBS TRBABURBR. 59 

JuBUce, O. S 10 00 

McCain, W. J 10 00 

McBachern, J. A 10 00 

Pearson, B. R 10 00 

Pride, W.T 10 00 

Robinson, T. F 10 00 

Sims, A. G 10 00 

Waller, G. P 10 00 

Welch, S. W 10 00 

Whitfield. J. B 10 00 

Wyman, B. L 10 00 

Total 26. Paid $260 00 

Received itbom Ck>uNBBLL0B8-BLBCT. 

Ard, E. B I 6 00 

Green, Henry 6 00 

Justice, R. L 5 00 

Lawrence, W. J. D 6 00 

Maples, W. C 6 00 

Robertson, W. H 10 00 

Tarn, S. S 10 00 

Thigpen, C. A 10 00 

Totals. Total amount 156 00 

Received fbom Delegates to MoNTOoiaaiT Session. 

Autauga 

Baldwin—J. H. Hastie 6 00 

Barboui^-W. G. Lewis 5 00 

J. L. Houston ' 6 00 

Bibb— M. C. Schoolar 6 00 

Blount 

Bullock— P. P. Dixon 5 00 

T. J. Dean 5 00 

Butler — Henry Green 5 00 

Calhoun— J. M. Whiteside 6 00 

J. C. Brock 5 00 

Chambers 

Cherokee— A. C. Shamblin 6 00 

Chilton 

Choctaw 

Clarke 



a ■ 



• • • 



• • • 



go THE MEDICAL A8B00IATI0N OF ALABAMA. 

Clay 

Cleburne— S. L. Block 5 00 

Coffee— P. T. Fleming 6 00 

Colbert 

Conecuh— J. N. Mixon 6 00 

Coosa— J. C. Cousins 5 00 

Covington 

Crenshaw — J. R. Horn 6 00 

Cullman 

Dale— E. B. Ard 6 00 

Dallas— W. H. Taylor 6 00 

D. B. Edwards 5 00 

DeKalb 

Elmore— W. A. Huddleston 6 00 

Escambia — ^W. L. Abemathy 6 00 

Etowah— W. J. D. Lawrence 5 00 

Payette— J. Q. Smith 5 00 

Franklin 

Geneva — ^R. L. Justice 5 00 

Greene 

Hale— J. P. Borden 5 00 

Henry— M. S. Davis 6 00 

Jackson — ^W. C. Maples 5 00 

Jefferson— W. H. Wilder 5 00 

C. Wilson 5 00 

Lamar — D. C. Morton 6 00 

Lauderdale 

Lawrence — B. F. Etheridge 5 00 

Lee— W. B. Watkins 6 00 

Limestone 

Lowndes — Frank Shackleford 6 00 

Macon — ^P. Reynolds 6 00 

J. T. May 6 00 

Madison 

Marengo— J. R. Goodloe 5 00 

W. C. Lockhart 5 00 

Marion — W. R. Goggans 5 00 

Marshall 

Mobile — P. J. M. Acker 6 00 

W. T. Henderson 5 00 

Monroe — W. J. Mason 5 00 

J. M. Higgins 6 00 



• • • 



• • • • 



• • 



• • • 



REPORT OF THE TRBABURSR. g^ 

MonUromery — ^J. M. Sadler 6 00 

R. Qoldthwaite 6 00 

Morgan 

Perry 

Pickens 

Pike— J. W. Robertson 6 00 

Randolph 

Russell — ^T. A. Johnson 6 00 

Shelby— D. L. Wilkinson 6 00 

St Clair 

Sumter — ^J. N. Qilmore 6 00 

Talladega 6 00 

Tallapoosa — H. S. Bruce 6 00 

Tuscaloosa — S. T. Mayfleld 6 00 

Walker— S. O. Oilder 5 00 

Washington 

Wilcox 

Winston — ^A. S. Palmer 5 00 

Total from delegates 1256 00 

Dollar Dues Rbceivkd from CouifTT Societibs: 

Autauga 5 00 

Baldwin 4 00 

Barbour 18 00 

Bibb 9 00 

Blount 

Bullock 16 00 

Butler 2 00 

Calhoun 21 00 

Chambers 7 00 

Cherokee 10 00 

Chilton 4 00 

Choctaw 6 00 

Clarke 

Clay 

Cleburne 9 00 

Coffee 11 00 

Colbert 7 00 

Conecuh 18 00 

Coosa 9 00 

Covington 

Crenshaw 8 00 



I 



■ • * • 



• • • • 



32 THE MEDICAL ASBOOIATION OF ALABAMA. 

Cullman 13 00 

Dale 9 00 

Dallas 18 00 

DeKalb 

Elmore 13 00 

Bscambia 7 00 

Etowah 17 00 

Fayette 6 00 

Franklin 

Qeneya 3 00 

Oreene 

Hale 12 00 

Henry 10 00 

Jackson 9 00 

Jefferson 91 00 

Lamar 7 00 

Lauderdale 7 00 

Lawrence 7 00 

Lee 

Limestone 

Lowndes 7 00 

Macon 6 00 

Madison 22 00 

Marengo 14 00 

Marion 6 00 

Marshall 2 00 

Mobile 26 00 

Monroe 5 00 

Montgomery 39 00 

Morgan 

Perry 10 00 

Pickens 

Pike 8 00 

Randolph 19 00 

Russell 4 00 

Shelby 8 00 

St Clair 9 00 

Sumter 11 00 

Talladega 14 00 

Tallapoosa 4 00 

Tuscaloosa 14 00 

Walker 9 00 



REPORT OF THE TREASURER. 33 

Washington 8 00 

Wilcox 

Winston 4 00 

Total from 54 County Societies |632 00 

MISCELLANEOUS BBCEIFT8. 

Dr. M. R. Seay, Berry Station, for Transactions 1 00 

Dr. S. E. Wlnnemore, for Transactions 1 00 

Dr. A. A. Kirk, for Transactions 1 00 

Total I 8 00 

BECAPITULATXON. 

To Balance on hand last report 11.442 03 

To Annual Dues from 93 Counsellors | 980 00 

To Annual Dues from 8 Counsellors-elect.... 65 00 

To Annual Dues from 54 County Societies.... 632 00 

To Annual Dues from 51 Delegates 256 00 

To Miscellaneous receipts 3 00 — 1,875 00 

Total $3,317 08 

DISBUBSEMENTS. 

By Geo. P. Waller, salary as Sec | 250 00 

To expenses Montgomery Session 69 65 

To A. H. Montgomery, Assistant Sec 20 00 

To Geo. S. Waller, Contingent fund 16 66 

To Mailing report Board Censors 27 50 

To Brown Printing Co., Transactions, etc 1,287 65 

To Telegram Dr. Sanders ac. Morris failure 32 

.To W. A. Graham, Counsellors fee returned 10 00 

To Geo. P. Waller for badges Selma Session 17 00 

To H. G. Perry, salary and stamps 110 00 — 1,808 77 

Balance on hand |1,608 26 

All the Counsellors have paid their dues. One Counsellor-elect, 
Dr. W. W. Watson, did not accept the position. 

Dr. A. J. Coley, reported last year as haying failed to pay 
dues, had paid, an error was made. His name has been reinstated 
on roll by order of Board of Censors. 



g4 THE MEDICAL AB800IATI0N OF ALABAMA. 

The report of the Publishing Ck)mmittee was then 
announced as in order. 

Owing to the non-arrival of Secretary Waller, who is 
Chairman of the Publishing Committee, the rendering 
of this report was necessarily postponed. 

REPORT OP THE PUBLISHING COMMITTEE. 

(Although submitted on the last day of the seBsion, It Is printed 
here In Its usual place.) 

To the President and Memhera of the Medical AaaodatUm of the 
State of Alabama: 

We beg leave to submit the following report: 

Eleven hundred and fifty copies of the Transactions of the 
last meeting of this Association were printed and distributed at a 
cost of 11,170.88. 

The volumes were distributed as follows: 

To 18 Grand Senior Life Counsellors, 2 vols, each 36 

To 100 Counsellors, 2 volumes each 200 

To 47 delegates, 2 volumes each 94 

To 630 members of county Societies, one volume each 6SG 

To 9 correspondents, one volume each 9 

To Reorganization Committee of American Medical Associa- 
tion (upon request) 4 

To Medical College Libraries, Medical Registers, and U. S. 

Government 10 

To Secretary's Ofllce 2 

To Newspapers of Alabama 28 

To Members-elect of General Assembly 37 

To Alabama Historical Society 1 

To Dr. C. A. L. Reed, President American Medical Association. . 1 

To N. Y. Academy of Medicine 1 

MisceUaneous 13 

Deposited in Ofllce State Board of Health 84 

Total 1,160 

The Committee regrets to state that the volume was unusually 
late in being issued from the press. Delays occurred which could 
neither be foreseen nor prevented. The causes of delay will not 
be elaborately stated, but the Committee will endeavor to profit by 
the experience acquired and hopes to be able to have the next volume 
published much more promptly than the last was done. 

G. P. Waller, M. D., Chairman. 
W. H. Sanders, M. D., 
J. C. LbGraux), M. D., 

Committee. 



REGULAR REPORTS. 55 

All of the above reports were, under the rules, re- 
ferred to the Board of Censors. 

Reports of special committees were then called for, 
but none were submitted. 

Under the head of miscellaneous business, Dr. Har- 
per, of Selma, moved that the order of exercises, as an- 
nounced in the programme, be changed, and that in- 
stead of an evening session an afternoon one, beginning 
at four o'clock, be held. He explained that this change 
would permit the members of the Association to attend 
an entertainment to be given at the Opera House to- 
night. He expressed the opinion that some recreation 
should be mixed with work and that the members would 
enjoy the entertainment. 

Dr. Gay, of Selma, stated that the manager of the 
entertainment had declined to make any concessions 
as to admission fees to members of the Association, not- 
withstanding the fact that if the proposed change in 
the programme should be made, very likely, a large num- 
ber of the visiting doctors would attend. 

He insisted that this indisposition on the part of the 
management to be generous to the doctors should be 
understood. He furthermore notified the members of 
the Association that an invitation is extended them to 
witness a game by the Selma Baseball Association dur- 
ing the afternoon, w^hich would no doubt aflPord them 
some amusement. 

Dr. Sanders said that the reasons assigned by the 
author of the motion (Dr. Harper) for changing the 
order of exercises on the programme appeared to him 
wholly inadequate, and he expressed the hope that the 
members would prefer to adhere to the programme, as 
printed, and that they would refuse to vary it for an 
amusement of the kind proposed. After some further 
debate, the motion of Dr. Hari)er was defeated. 

EVENING SESSION. 

Call to order by the President at 8 :10 p. m. 

The President announced as the first order of busi- 
ness: The Address of the Historian, who for this oc- 
casion is Dr. J. W. Palmer, of Opelika. The Presi- 
dent stated that information had bera received from Dr. 
Palmer that he was unavoidably prevented from being 
5 



ee THE MEDICAL A8800IATI0N OF ALABAMA. 

present, but had sent the manuscript of his address. 
The President then appointed Dr. E. L. Marshal, of 
Mobile, to read the address, which he did. 

(For pubUshed address see Appendix). 

Dr. S. G. Gay asked permission to interrupt the 
regular order and moved that all visiting physicians 
present be accorded the privileges of the floor. 

Dr. Sanders asked that the names of the visiting 
physicians included in the motion be announced to the 
Association, whereupon. Dr. Gay mentioned the name 
of Dr. Michael Hoke, of Atlanta, Ga. Dr. Gay's mo- 
tion was adopted . 

The President then announced that the next regular 
order was the reading and discussion of the Regular Re- 
ports, and suggested that some rule as to time allowed 
for discussion should be adopted. After some debate, 
it was moved by Dr. Mar^chal that in the discussion of 
papers the speakers be limited to five minutes each. 
Adopted . 

Dr. Bankston, of Birmingham, presented the first 
regular report, the subject being : The Future Outlook 
of Medicine Is Toward Prevention. The subject was 
discussed by Drs. LeGrand, Purifoy, Camp, Sanders, 
Casey, Starr, Moon, and Parker, Dr. Bankston closing 
the discussion. 

(For the pubUshed paper and discussion thereon see the Appendix 
of Medical and Sanitary Dissertations and Reports). 

Dr. M. B. Cameron, of Sumterville, presented the 
next report, subject: Pernicious Vomiting in Preg- 
nancy . 

Discussed by Drs. Ward, Harrison, McCain, and 
Copeland. Dr. Cameron closed the discussion. 

(For the published paper and discussion thereon see the Appendix 
of Medical and Sanitary Dissertations and Reports). 

The next report was by Dr. A. M. Stovall, of Jasper, 
on: The Therai)eutic Uses of Water. 

After the completion of this report, the hour being 
late, Dr. Gay moved that the Association adjourn. 
Adopted, 



BEGULAB HEFORTB. g7 

SE€X)ND DAY — ^WEDNESDAT^ APRIL 17TH. 
MORNING SESSION. 

C5all to order by the President at 9 :15 a. m. 

Under nnflnished business the discussion of Dr. Sto- 
vall's paper was announced as the first order. Paper 
was discussed by Drs. Nicholson and Sellers. 

(For pabMshed paper and discussion see Appendix). 

The next regular report was by Dr. R. S. Hill, of 
Montgomery, on: Ovarian Cysts. 

During the reading of the paper Dr. Hill exhibited 
a number of beautiful specimens of cysts, in alcohol, 
which he had removed from patients by operation. 

After the completion of Dr. Hill's paper Dr. Gay 
called attention to the fact that at a later period in the 
order of exercises Dr. J. A. Ooggans, of Alexander City, 
would present a paper on the same subject and, believing 
that it would be agreeable to the members of the Associa- 
tion to hear Dr. Qoggans's paper now, he moved that Dr. 
Goggans be granted the privilege of reading it at this 
time, as both papers could then be discussed together. 
The motion was adopted, whereupon. Dr. Goggans pro- 
ceeded to read his paper. He, also, exhibit^ to the 
members a number of specimens of ovarian cysts, re- 
moved by operation. 

The papers of Drs. Hill and Goggans were discussed 
by Drs. Jones, Hudson, Copeland, Harper, DuBose, 
and Morris, the authors of the two papers, closing the 
discussion. 

(For pabllshed paper and discussion see Appendix). 

The hour of eleven o'clock having arrived, the Presi- 
dent announced that the regular order at this hour is 
the Jerome Cochran Lecture, which Dr. Osier, of Bal- 
timore, had been invited to deliver. He said that Dr. 
Osier had not arrived and he had no assuran<;e that 
he would arrive during the meeting. 

Dr. R. S. Hill, offered the following resolution: 

Resolved, That should Dr. Osier fall to arrive during the meet- 
ing, the President be requested to communicate with him and. If 
possible, obtain a copy of his Lecture for publication In the volume 
of Transactions of this meeting. Adopted. 



68 THE MEDICAL ASSOCIATION OF ALABAMA. 

Dr. Waller called attention to the fact that the name 
of Dr. Hoke, of Atlanta, a visiting physician, now pres- 
ent, appears on the programme for tomorrow and moved 
that he be granted the privilege of presenting his paper 
at this time. The motion was adopted. 

Dr. Hoke then proceeded to read a very elaborate and 
scientific paper, accompanied by a number of well-exe- 
cuted illustrations, on: The Pronated Foot. 

The paper was discussed by Drs. Copeland, Morris 
and Rogers, Dr. Hoke closing the discussion. 

(For pablished paper and discussion see Appendix). 

The President announced the subject of the next pa- 
per to be: Endometritis, its Treatment in the Home, 
with Report of Oases, by Dr. C. S. Chenault, of Mt. 
Hope. 

Dr. Chenault not being present, and not having for- 
warded his manuscript, the subject was passed. 

Dr. E. B. Ward, of Selma, then read a paper on: 
Reflex Neuroses in Women. 

Dr. Gay called attention to the fact that a paper by 
Dr. W. T. Eckley, of Chicago, on a kindred subject to 
that of the one just read is on the programme for to- 
morrow, but on account of illness. Dr. Eckley could not 
be present. He had, however, sent his manuscript, 
which Dr. Gay moved be now read, as time could be 
economized by discussing that paper and Dr. Ward's 
together. At the request of the President, Dr. Moody, 
of Bailey Springs, read Dr. Eckley's paper, the subject 
being: Medical and Forensic Importance of Reflexes. 

On motion, the meeting then adjourned. 

AFTERNOON SESSION. 

The Association was called to order at 3 :10 p. m., by 
the President. 

Under unfinished business President Cunningham 
spoke in commendatory terms of the two last papers 
read — those of Drs. Ward and Eckley — ^and expressed 
regret that illneps had prevented Dr. Eckley from being 
present and participating in the meeting. 

(For pablished papers see Appendix). 

The following communication from Dr. Perry, the 
Treasurer, was received, ordered to be read, and was re- 
f ^rr^d to the Board of Censors : 



ftEOVLAtt HEPORira. Q9 

Mr. President and Oentlemen of the Medical Association of the 
State of Alabama: 

I have the honor to state that since the adoption of the new 
method of securing mailing lists for the distribution of the volume 
of transactions I have not had a single complaint of failure to re- 
ceive the volume. 

In my last annual report I called the attention of the Board 
of Censors to the fact that there was a surplus of more than a 
thousand dollars In the Treasury, and suggested that some dispo- 
sition be made of It The failure of the banking house of Joslah 
Morris ft Co., In which there was seven hundred and forty-nine dol- 
lars and ninety-one cents, has relieved the pressing necessity of 
such action, but our Income exceeds our expenses, hence any sur- 
plus there may be on hand lies Idle. I would recommend that the 
Treasurer be authorized, with the consent and approval of the Presi- 
dent and Senior Censor, to loan the surplus. 

As one of the designated banks of deposit for the funds of the 
Association has failed, and as there Is a National Bank In my 
home town, Greensboro, I respectfully request that said bank be 
designated as one of the banks of deposit for the funds of the Asso- 
ciation. Such an arrangement would be both convenient and eco- 
nomical, by enabling me to avail myself of the convenience of trans- 
acting business through a home bank and also by saving exchange. 

Dr. A. J. Coley, of Alexander City, was dropped from the 
roll of counsellors last year at Montgomery for non-payment of 
dues. I beg to say that a clerical error led to his being dropped. 

It win be remembered that owing to the very unusual flood that 
prevailed at the time the meeting convened I was unable to reach 
Montgomery until the third day of the meeting. In the meantime. 
Dr. Waller, the Secretary, had been appointed temporarily to dis- 
charge the duties of Treasurer, and when I arrived I relieved him. 
In the transfer of accounts that necessarily took place betwixt 
Dr. Waller and myself the clerical error that led to the dropping 
of Dr. Coley occurred. 

The records show that he had uniformly paid his dues In ad- 
vance and the series of receipts he exhibited placed the matter be- 
yond dispute. I hope, therefore, that the Association will correct 
the error made, by re-lnstatlng Dr. Coley in the House of Coun- 
sellors. 

Very respectfully, 

H. O. Pkbbt, 

Treasurer. 

Dr. L. W. Johnston, of Tuskegee, then read a paper 
on : Acute Entero-Colitis in Inftincy. 



70 THE MEDICAL ABBOOIATION OF ALABAMA. 

Discussed by Drs. Harper and Parke, Dr. Johnston 
closing. 

(For published paper and dlacuBsion see Appendix). 

Dr. F. A. Webb, of Calvert, next read a paper on: 
Pathological Conditions Causing Abortion and Pre- 
mature Labor, with Reports of Cases. 

(For published paper see Appendix). 

Needed Reforms in the Treatment of Insane Crimi- 
nals, by Dr. W. G. Somerville, of Tuscaloosa, was the 
subject of the next paper read. 

Discussed by Dr. Cunningham (Dr. Bell in the 
chair), and by Drs. Moody, Parke, and Harris, Dr. 
Somerville closing. 

(For pabliahed paper and discussion see Appendix). 

Dr. Judson Davie, of Cowikee, then read a paper on : 
Mortality in Our Prison Population. 

Discussed by Drs. Sellers and Jenkins, Dr. Davie 
closing the discussion. 

(For pnblished paper and discussion see Appendix). 

The Association then adjourned. 

EVENING SESSION. 

At 8 :30 p. m. the Association was called to order in 
the Opera House by President Cunningham, a fair au- 
dience of citizens, in addition to the members of the 
Association, being present. 

The Monitor's address was first in order, to deliver 
which on this occasion, the President introduced Dr. W. 
E. B. Davis, of Birmingham. 

The address engaged the close attention of the audi- 
ence throughout and elicited frequent applause. 

The Orator's Address was next in order, to deliver 
which, on this occasion, the President introduced Dr. 
W. Groce Harrison, of Talladega. 

Judging from the marked attention and frequent and 
hearty applause the orator received, the audience must 
have been highly entertained. 

(For the published addresses see Appendix). 

The Association was then transferred from the Opera 
House to the spacious and flower-wreathed dining hall 
of Hotel Albert, where the visiting members became 
the welcome guests of the Dallas County Medical So- 
ciety at long and luxuriant banquet tables. After full 



RBQVLAtt BSPOBTB. ^l 

justice had been done to a sumptuous menu, a spark- 
ling flow of wine and of after-dinner wit wound up an 
occasion that richly justified the guests in unanimously 
voting the Dallas County Medical Society a most charm- 
ing and generous host. 

Adjournment took place at quite irregular and un- 
certain hours. 



THIBD DAY — THURSDAY, APRIL 18tH. 

Call to order at 9 :30 a. m., by the President, in the 
Hall of the Young Mens' Christian Association. 

Under the head of unfinished business the following 
r^^lar reports were called : 

The Prevention of Infectious Diseases, by Dr. T. A. 
Casey, of Albertville. Bead by the author and discussed 
by Drs. Jones (E. A.), Rogers, Coley, and Peters, the 
author of the paper closing the discussion. 

(For publiBhed paper and dUcasslon see Appendix). 

What is the Best Closure and Dressing in Aseptic 
Cases? by Dr. Goldsby King, of Selma. Read by the 
author and discussed by Drs. Hudson, Morris, Peters, 
Goggans, Cunningham, and Brown, the author of the 
paper closing the discussion. 

(For published paper and discussion see Appendix). 

At this point an invitation was extended to the Asso- 
ciation by Dr. King to visit his Sanitorium (in Selma), 
which was accepted. 

President Cunningham Interrupted the regular or- 
der to announce the following Committee on the nomi- 
nation of Counsellors: Drs. G. A. Hill, of Talladega; 
L. W. Johnston, of Tuskegee; T. E. Dryer, of Hunts- 
ville; M. B. Cameron, of Sumterville; E. B. Ard, of 
Ozark. 

The Microscope in the Hands of the Qeneral Prac- 
tioner, was the subject to be next presented. Dr. Q. 
Heustis Fonde, of Mobile, who was to present this sub- 
ject, not having arrived, it was informally passed. 

The subject of the next paper to be presented was: 
Peculiar Forms of Malaria, by Dr. H. T. Inge, of Mo- 
bile. Dr. Inge not being present and not having sent 
his manuscripti the subject was passed. 



7^ THE MEDICAL ASaOCIATIOlf OF ALABAMA. 

Hydrocephalus, Its Most Logical Theory, and the 
Operation Based Thereon, was the subject of the next 
paper to be presented. Dr. H. M. Hunter, of Union 
Springs, who was to present this subject, not being 
present, and not having sent his manuscript, the sub- 
ject was passed. 

The Diseases of the Tennessee Valley was announced 
as the next subject on the programme. Dr. M. W. Mur- 
ray, of New Decatur, who was to present this subject, 
not being present and not having sent his manuscript, 
the subject was passed. 

The Climatic Effects in Talladega County on Diseases 
Common in Alabama was the next subject announced. 
Dr. S. W. Welch, of Talladega, read a paper on this 
subject, which was discussed by Drs. Harrison, Sims, 
Moody, McKittrick, Cunningham, and Robinson, the 
author of the paper closing the discussion. 

(For published paper and discussion see Appendix). 

The regular reporters having all been called, volun- 
teer papers were declared in order. 

The first of these was read by Dr. E. A. Jones, of Bir- 
mingham, subject: The Widal Reaction in Typhoid 
Fever. Discussion by Drs. Brown, Peters, and Sellers, 
Dr. Jones closing. 

(For published paper and discussion see Appendix). 

Dr. S. A. Billing, of Montgomery, read the next paper, 
subject: Anaesthesia and Anaesthetics. Discussed by 
Drs. Moody, Peters, and Stubbs, the author of the 
paper closing the discussion. 

(For published paper and discussion see Appendix). 

Dr. Judson Davie, of Cowikee, asked and received 
unanimous consent to offer a resolution. He then read 
the resolution as follows : 

Resolved, That the Committee of Public Health of this Asso- 
ciation be and is hereby authorized and instructed to prepare and 
submit to the next General Assembly a bill for such legislation as 
will, in the judgment of the Committee, efCectually prevent such 
convicts as are physically unfit to work in mines from being re- 
quired to perform labor of that kind, and that said Committee shall 
urge the enactment of such bill into law. 

Under the rule, the resolution was referred to the 
Board of Censors. 



VOLUNTEER PAPERB. 73 

The Doctor in Politics was the subject of a pscper pre- 
sented by Dr. J. C. LeQrand, of Birmingham. 
Discussed by President Cunningham. 
On motion the Association adjourned. 

AFTERNOON SESSION. 

Call to order at 3 p. m. by the President. 

Dr. Waller, the Secretary, read the following letter : 

TuBLOOK, Cal., 10th April, 19U1. 

George Piatt Waller, M. D„ Secretary Medical Association of the 
State of Alabama, Montgomery, Ala.: 

DiAB Doctob: 

I was put on the Sociological Committee of the Trl-State So- 
ciety and asked to bring some of the Important questions that ought 
to be considered and handled by medical men before the Medical 
Association of the State of Alabama at Its next general meeting, 
with the view of seeking the co-operation of that Influential body. 

I, therefore, send you a paper which gives a forecast of what 
I believe must ultimately be the ground taken for the extirpation 
of crime and the rapid Improvement of the race. 

Please give my compliments to Dr. Cunningham and bespeak his 
co-operation with the Trl-State Medical Association In Sociological 
science. 

What you may do with the paper I do not know, as I am now 
a non-resident of Alabama and I can not, therefore, urge any claim 
to personal consideration. 

If you can not use the paper at the coming meeting or publish 
it In the Transactions, may I ask you to kindly return It to me, as 
I want to be able to show the Trl-State people that I have done 
my duty as a committeeman according to my lights. 

With best wishes to old friends and for the success of the 
Association, believe me, dear doctor. 

Tours very truly, 

John B. Puboon. 

Motion was made and adopted that inasmuch as Dr. 
Purdon, the author of the letter just read, was formerly 
a prominent and valued member of this Association, the 
communication to which he alludes be referred to the 
Publishing CJommittee, with the hope that it will be 
found practicable to include it with the papers to be 
published in the volume of Transactions of this meet- 
ing. 



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70UJVTKBR PAPERS. 75 

On motion the letter was referred to the Board of 
GenBors. 

Influensa, was the subjeet of a paper presented by 
Dr. W. W. Harper, of Selma, and discussed by Drs. 
Waller, Peters, Cameron, Hooper, Duggar, Goggans, 
Wilkinson, Williams, and Cunningham. Dr. Harper 
closed the discussion. 

(For pnbliflhed iM^per and diBcussion see Appendix). 

The subject of the next paper on the programme was : 
Neglected Therapeutics, by Dr. W. H. Banders. The 
duties of Dr. Sanders in connection with sittings of the 
Board of Censors were such as to render it impossible 
for him to be in the hall, hence the subject was passed. 

Dr. Q. H. Fonde, of Mobile, having arrived, was 
granted the privilege of reading his paper, which had 
been passed over in the regular order. Subject : The 
Microscope in the Hands of the Qeneral Practitioner. 

Discussed by Drs. E. A. Jones, DuBose, Cameron, 
Moody, Hooper, Parker, and Camp, the discussion being 
closed by the author of the paper. 

(For pubUshed paper and discuBsion aee Appendix). 

The Administration of AnsBsthetics was the next sub- 
ject presented to the Association, which was done by 
Dr. B. B. Bogan, of Selma. 

Dr. Oay, of Selma, then presented the subject: Co- 
caine An»8thesia by Lumbar Puncture. 

Discussed by Drs. Morris, Parker, and Camp, Dr. 
Gay closine the discussion. 

(For pnbll&ed paper and discuasion see Appendix). 

Dr. W. H. Hudson, of LaFayette, next read a paper 
on : Actinomycosis. 
Discussed by Drs. Duffgar and Parker. 

(For pubUshed paper and discussion see Appendix). 

The meeting then adjourned. 

FOURTH DAY^ FRIDAY, APRIL 19TH. 

Gall to order at 9 a. m., by the President. 

Dr. Q. P. Waller, Secretary of the Association, sub- 
mitted his Annual Report, which under the rules, was 
referred to the Board of Censors. Dr. Waller, Chair- 
man of the Publishing Committee, also submitted a re- 
port from that Committee. Referred to the Board of 
Censora. 



76 THE MEDICAL ASSOOIATION OF ALABAMA. 

(These reports will be found printed in their usual place, that la, 
in the Minutes of the first day. 

The Report of the Board of Censors was then an- 
nounced to be in order. The Chairman of the Board 
not being in the hall, it was stated that he was busily 
engaged in his room, at the hotel, in completing the Re- 
port 

It was moved and adopted that the Association, while 
waiting for the report, take a recess of fifteen minutes. 

At the expiration of the recess the Association was 
called to order, whereujwn, the Report of the Board of 
Censors ^^as submitted by Dr. W. H. Sanders, Senior 
Censor, as follows : 



THE TWENTY-EIGHTH ANNUAL REPORT OF THE BOARD OF 
CENSORS, INCLUDING REPORTS OF THE STATE BOARD OF 
MEDICAL EXAMINERS AND OF THE COMMITTEE OF 
PUBLIC HEALTH. 

PART I. 

The Board of Censors begs to submit this, its Twenty- 
Eighth Annual Report. 

THE president's MESSAGE. 

After mature consideration of such recommenda- 
tions in the President's message as require action on 
the part of this Association, the Board unanimously 
submits the following views thereon: 

With the spirit of enthusiasm and of loyalty to our 
organization which pei-vades the message of the Presi- 
dent, the Board is in full sympathy, and believes that 
the words of the President— so warmly and well spoken 
— ^will strengthen the courage and stimulate the efforts 
of the members to labor more zealously and fraternally 
than ever before to achieve the great objects for which 
we are united. Could every member of the profession 
in the State become dominated by such a spirit, not 
only would success be assured, but quickly and com- 
pletely won. Whilst the Board endorses the message 
in the respects stated, it feels compelled to take issue 
with the first specific recommendation therein, which 
appears in the following words : 



BEPORT OF THE BOARD OF CENSORS. 77 

"1. That a member in good standing of any County 
Medical Society in the State may become a member of 
the Medical Association of the State of Alabama with 
all the rights and privileges now allowed delegates 
upon the payment of an annual fee of five dollars. 

2. That after being a member and paying dues at the 
rate of five dollars per annum, for twenty years, he shall 
become a life member without further payment of dues." 

This recommendation seems to proceed from a mis- 
apprehension of the attitude which the members of the 
Countv Medical Societies now bear to the Association. 

Article 5 of Section 3 of the Constitution of the Asso- 
ciation reads as follows: 

"All members of County Societies which hold char- 
ters from the Association shall be members of the Asso- 
ciation." 

Inasmuch as all members of County Medical Societies 
in affiliation with this Association are now declared by 
the Constitution to be members of the Association, it 
would, clearly, be a work of sux)ererogation to embody 
a principle in the Constitution which it already con- 
tains. 

The recommendation, however, proposes to go further 
than does the Constitution and to confer ui)on members 
of County Societies who pay to the Association annual 
dues of five dollars all of the rights of del^ates, that is, 
in addition to the privileges of the fioor, the right of 
voting, and after the expiration of twenty years to re- 
lease them from the payment of further dues. 

The adoption of this recommendation would not only 
overthrow one of the fundamental principles that un- 
derlie our organization, but would, in the opinion of 
the Board, operate unfairly and unjustly in practice. 

The fact, often overlooked, that this Association is a 
quasi-l^islative body must be kept prominently in mind. 
In this respect it differs widely from an association of 
medical men organized solely for scientific and social 
purposes. Obviously, in an association of the latter 
kind no distinctions as to membership, and as to the 
rights adhering thereto, could proi)erly be made, but in 
an organization such as ours, the reverse is true, that 
is, when it exercises the high legislative function with 
which it is endowed by the State, representation in it 
should be as fixed as in any other legislative body. Not 



78 THB MEDICAL ABBOCIATIOV OF ALABAMA. 

only BOy the representation must be equitably dis- 
tributed to the different counties of the State. This 
principle is too obvious and too just to need argument 
in support of it. 

Were the recommendation of the President adopted, 
an indefinite factor as to membership in a legislative 
body would be introduced, that is, the number of vot- 
ing members added might vary anywhere from one to 
about eight hundred, and should all of the physicians 
in the several counties become members of their respec- 
tive societies, the addition of voting members might 
amount to about fifteen hundred, with a continual in- 
crease, as the number of doctors in the State increases. 
A large proportion of the "legislators" thus added might, 
and most probably would, come from a few counties, 
and thus give to such counties an undue and unjust vot- 
ing strength in the Association. Manifestly, such a 
I)olicy would rapidly sow the seeds of dissatisfaction, 
and lead to disintegration and destruction of the entire 
system of organization. 

Further, the principle sought to be introduced pro- 
poses to confer upon the members of the county socie- 
ties the privilege of purchasing the right to vote in the 
Association, a privilege which it requires no prophetic 
eye to see might be greatly abused and thus lead to the 
introduction of the lowest political methods into this 
body. 

A designing and ambitious member might easily util- 
ize the privilege thus accorded to promote his chances 
for office, or to advance any scheme in which he possessed 
a personal interest. This suggestion might be pro- 
nounced an unjust reflection, but, in making constitu- 
tions and passing laws and ordinances, it is wise to 
keep in view all possible dangers and abuses, therefore, 
this one is pointed out. 

At present, whenever the Association exercises its 
legislative function representation therein is not only 
definitely fixed as to number, but is so adjusted as to 
be fair to all parts of the State. No county and no two 
or three counties can possibly acquire undue infiuence 
or exercise dangerous power. Evidently, this point 
was carefully guarded by the lamented leader who 
masterfully conceived the philosophical principles upon 
which our system of organization is based, and who so 



RXPORT OF THE BOABD OF CENSORS. 79 

logically put together the details of its structure from 
foundation to dome. As is known, the voting strength 
of this Association consists of one hundred counsellors 
and of one hundred and thirty-two del^ates. Doubt- 
less these figures were fixed by the author of the system 
after mature deliberation. Certainly the wisdom of so 
fixing the number of voters can be readily seen. This 
/Association, and the County Societies in affiliation 
therewith, was intended to be an organization of the 
entire medical profession of the State, not of a i>art of 
it, therefore, the principles of its organization were so 
formulated as to give to the profession of the State, 
speaking through delegates sent up from County Socie- 
ties, the controlling voice in all of its councils. 

Obviously, all of the members of County Medical So- 
cieties cannot attend every meeting of the Association, 
but their views can always be represented by delegates, 
instructed if need be, hence, the exercise of arbitrary or 
unwise power by any "ring^* or combination is effectu- 
ally prevented. Attention has already been called to 
the bad wisdom of permitting members to purchase the 
privilege of voting. It would be a parallel paradox 
were the citizens of the various counties of the State 
permitted, in addition to sending their fair proportion 
of representatives to the General Assembly, to pur- 
chase the right of voting therein upon the payment of 
a certain sum of money and without any restriction as 
to the number that might so acquire the right. That 
every principle of equity would be violated by such a 
legislative system is too obvious to require discussion. 

The Constitution of this Association, which for twen- 
ty-eight years has stood the test of practical application, 
wisely restricts the right of voting to counsellors and 
delegates, both of whom are chosen by their colleagues. 
The recommendation of the President would confer upon 
certain members the privilege of asserting this right for 
themselves and wholly independent of being chosen by 
their colleagues. 

To retain their membership in the Association coun- 
sellors must attend at least one meeting in three, an ob- 
ligation imposed no doubt to compel them to be present 
frequently enough to become familiar with the merits 
of the system and in full sympathy with its aims and 
purposes. 



go THE MEDICAL ABBOOIATION OF ALABAMA. 

No such obligation as to attendance would be im- 
posed upon the class of voters admitted by the Presi- 
dent's recommendation. Prompted by misguided zeal 
and filled with ambition to become reformers, the dan- 
ger and probability is that many of them would attend 
but spasmodically and, ignorant of the philosophy un- 
derlying the system, would recklessly assail and attempt 
to destroy what older and, we may say, wiser heads had 
labored years to build up and establish. As education is 
the only remedy for antagonism born of ignorance, so, 
familiarity with the logic of our system, acquired by 
study and by attendance upon the meetings of this As- 
sociation, is the only remedy against hostility to it 

It is well known that there are members of the pro- 
fession in the State opposed to all organization* and 
that there are others hostile to our system of organiza- 
tion, their hostility growing out of a failure to compre- 
hend it. 

Were the President's recommendation adopted, it 
would be easily within the range of possibility for these 
two classes of our enemies to form a conspiracy for the 
overthrow of our organization, and to carry out such 
conspiracy. They only need to go into a meeting of the 
Asssociation in such number as to dominate it and to 
declare by resolution that the organization shall be, and 
is hereby, dissolved, and so notify the State authorities, 
in order that they shall no longer look to us to advise 
or execute in public health matters. Would it be wise 
to let into our citadel such a Trojan horse as that? Were 
the very same men who would thus recklessly destroy 
the symmetrical and coherent system which our pre- 
decessors built up compelled to acquire the right of vot- 
ing by compliance with present constitutional provis- 
ions, the certainty is that many or all of them would, 
by acquiring familiarity ^ith the system, become its 
warm and enthusiastic advocates and supporters. 

Another and a very fatal objection to the recommen- 
dation in question consists in the ease with which the 
instructions of any County Society to its delegates, ap- 
pointed to attend a meeting of the Association, could 
be completely nullified. For instance, suppose an im- 
portant question should arise in reference to which any 
given County Society, consisting, say, of fifty members, 



BEPOBT OF THE BOABD OF CENSORS. 81 

should desire to give its delegates express instructions. 
The question is thoroughly discussed in a full meeting 
and a decision reached by a vote of forty to ten. Ac- 
cordingly, the two delegates receive express instruc- 
tions from the Society as to how they shall vote upon 
the question. They attend the meeting of the Associa- 
tion and vote as instructed, but the ten members, who 
constituted the small and defeated minority in the coun- 
ty society, likewise attend and by purchasing the right 
to vote, nullify, five times over, the votes of the two 
delegates who represent the very large majority of the 
Society. 

It is no defense of the President's recommendation to 
claim that this would not happen. It is easily within 
the range of, not only possibility, but probability. It 
might be said that the forty members who decide as to 
the nature of the instructions given to the delegates 
could likewise attend the meeting of the Association and 
support their views with their votes, but would this be 
a desirable state of affairs? Would it not certainly 
transfer struggles, often local in character, from County 
Societies to this Association, and, thus, foment strife 
and discord in both places? Unquestionably. 

Another and overwhelming objection to the recom- 
mendation consists in the certainty that, if put into oj)- 
eration, it would materially weaken the strength of 
many of the County Societies and, not only so, would 
utterly destroy many of them. The County Societies 
are the pillars upon which this Association rests; de- 
stroy them, and, necessarily, the superstructure falls 
into a hopeless mass of ruins. Many members of Coun- 
ty Societies would utterly neglect the obligations due 
their home organizations and would find satiety of their 
desire for professional fellowship and scientific improve- 
ment hj attending one annual meeting of this Associa- 
tion. Under this condition of things, it would be very 
difficult or impossible to carry on public health work in 
the counties in accordance with our system. Whenever 
we, as an organization, cease to do public health work for 
the counties and the State, then, we release the State in 
some measure from obligation to protect us in our ef- 
forts to uphold the dignity and to elevate the standard 
of the profession. When such a condition arises the 

6 



g2 THE MBDIOAL A8800IATI0V OF ALABAMA. 

profession of medicine will be dragged down into the 
mire and rendered so disreputable that no decent man 
would desire to be a member of it 

It is confidently believed that this Association, with 
its proud record of achievements and the grand possi- 
bilities before it, will emphatically and overwhelmingly 
refuse to endorse a policy clearly calculated to lead to 
such results. Our system of organization has abundant- 
ly illustrated its wisdom by its fruits. Shall we weak- 
en its capacity for achievement or jeopardize its pros- 
pects for perpetuity by incorporating a measure ob- 
viously unfair and, therefore, unwise? 

The President, in speaking of the author of the sys- 
tem, uses the following warm, true, and eloquent words : 
"The mind that conceived the plan was a master mind ; 
the courage that prosecuted it was dauntless ; the states- 
manship and diplomacy that won it were matchless. 
"That mind, courage, and statesmanship are no longer 
available to plan, execute, and achieve, but they still 
live in the hearts of the members of this Association to 
inspire them with hope, to encourage them in their work, 
and as an example for their methods." 

Fortifying our position with this splendid eulogium 
upon the author of our system by the President, it would 
be a sufficient objection to the recommendation under 
discussion to say that Jerome Cochran did not embody 
it in the plan; on the contrary, he expressly provided 
that it should not be embodied. 

Would it not be a condemnation of his plan to incor- 
porate in it a feature so radically subversive of one of 
its fundamental principles? The system is beginning to 
attract wide attention and to be copied by other States. 
In this connection, permit us to say that inquiries for in- 
formation as to our system of organization have been 
received from various directions, notably, from the 
President of the Medical Association of the State of 
New York. A letter, recently received from Dr. G^eorge 
H. Simmons, Secretary of the American Medical Asso- 
ciation, and editor of the Journal of the Association, 
contains the following : "We are working to get a uni- 
form plan of organization adopted by all of the State 
Societies. Yours, in my estimation, is as nearly perfect 
as any, the only trouble is that it goes a little farther 



REPORT OF THE BOARD OF OENSORS. 33 

than the majority would want to go^ as I nnderstand 
it.'' 

Occupying the position that Dr. Simmons does, we re- 
gard this endorsement as emanating from, not only a 
highy but an unusually well-informed source. Let us 
not, then, mar our system by embodying in it a princi- 
ple against which there seem to be so many and such 
grave objections. 

The final argument against the adoption of the Presi- 
dent's recommendation, which the Board presents, is 
that in order to carry it into eflfect it would be necessary 
to apply to the General Assembly of the State for an 
amendment to our charter, and, that obtained, it would 
then be necessary to amend the Constitution of the As- 
sociation. 

For many and obvious reasons an application to the 
General Assemblv for an amendment to the charter 
would be attended by grave dangers, namely, of having 
other and undesirable changes made in our organic law. 
The Board recalls very vividly an able argument on this 
very point delivered by the President at the last meet- 
ing of this Association, in which argument he pointed 
out the dangers of making application to the General 
Assembly to amend the laws, now on the statute books, 
giving this Association its legal status and rights. This 
reason alone, did no other exist, would render the 
adoption of the recommendation impolitic and unwise. 
The arguments in behalf of our present system, and 
against the recommendation of the President, may be 
summarized as follows: 

1. The State Medical Association being the State 
Board of Health and, therefore, a quasi-l^slative body, 
the number of its members entitled to vote should be as 
definitely fixed as those of any other legislative body, and 
should be apportioned to all parts of the State upon a 
fair and equitable basis. The adoption of the recom- 
mendation of the President would violate both of l^ese 
propositions, by introducing an uncertain and con- 
stantly varying factor as to the number of members en- 
titled to vote, and by disarranging the fair and equitable 
distribution of them, thus leading to dissatisfaction and, 
possibly, to disorganization of many of the county so- 
cieties. 



g4 THB MEDICAL ASSOCIATION OF ALABAMA. 

2. The adoption of the recommendation would con- 
fer the privilege of purchasing the right to vote and 
would render the voter entirely independent of election 
by his colleagues, either of this Association, or of his 
county society. 

3. It liquid disarrange that fair and equitable ad- 
justment of the voting strength, now existing, between 
permanent members, or counsellors, and delegates, in 
which adjustment resides the great elements of safety, 
solidity and perpetuity. 

4. It would give to a minority of the members of 
any county medical society the opportunity of nullify- 
ing in the Association the expressed will of the majority 
of members in such society, as made known in the form 
of instructions to its delegates. 

5. It would give to members important rights with- 
out imposing ux>on them corresponding obligations. 

6. It would tend to weaken and to disintegrate the 
county societies, thereby impairing or destroying the 
foundations upon which the structure of this Associa- 
tion rests. 

7. The author of the system expressly and wisely 
provided against such a feature. 

8. Finally, in order to carry the recommendation 
into eifect, it would be necessary to apply to the Gten- 
eral Assembly to have the charter of the Association 
amended, an undertaking that would be fraught with 
much danger. 

Second Recommendation. 

The next recommendation the President makes is as 
follows : 

"I therefore suggest that the Association offer a prize of twenty- 
five dollars for the best paper upon any one subject pertaining to 
medical topography or climatology in this State, as a whole or a 
defined district" 

The Board has given this recommendation very care- 
ful study, and along with the President, deems it very 
desirable to obtain comprehensive, accurate, and ex- 
haustive papers on the subject named, but tiie Board 
also realizes that the subject is one which, altiiough 
comprehensive and at the same time full of interest- 



RSPORT OF TSje BOARD OF OBNSORB. g5 

ing details, i^nld be in danger of becoming ezhansted 
after a few years, that is to say, the data within reach 
of those who might feel inclined to compete for a prize 
would become exhausted. Any one who might propose 
to write upon climatological and topographical sub- 
jects would necessarily be compelled to draw his data 
largely from the reports of the Weather Bureau, from 
a study of the map of the State, and from the records of 
the vital and mortuary statistics of the State. 

Naturally, these sources of supply would be limited^ 
not limited if fully developed and made available, but 
limited on account of the lack of such development and 
availability. In other words, much work must be done in 
these fields by engineers, weather bureau employees, and 
gatherers of vital and mortuary statistics before doctors 
could find large data from which to draw conclusions and 
lessons — hence, after a few years, succeeding papers on 
these subjects would necessarily cover much the same 
ground and include much the same data that preceding 
ones had covered and included. 

It has been contemplated, whenever adequate salaries 
are obtained for the health officers of every county in 
the State, to require these officers, each for his own 
county, to prepare reports covering, as far as can be 
done, the ground recommended in the President's mes- 
sage. 

The Board is of the opinion that it would be best to 
develop this subject in the way just mentioned, and 
whilst endorsing the spirit of the President's recom- 
mendation, it suggests that the object sought be accom- 
plished, as well as can be, in the way just proposed, and 
without offering a prize therefor. 

Third Recommendation. 

With the view of providing for full reports of the dis- 
cussions had at meetings of the Association, the Presi- 
dent recommends the employment of a stenographer. 

The Board endorses this recommendation as worthy, 
at all events, of trial, with the intention of being guided 
in the future by the results obtained. A stenographer 
has been secured for this meeting at an expense of twen- 
ty-five dollars, which amount the Board recommends be 



gg TB£ MEDICAL ABSOOtATIOn OP ALABAMA. 

paid in accordance with the methods preBcribed for the 
payment of all other expenses. 

Fourth Recommendation. 

The fourth recommendation of the President is that 
Hhe county societies have annual, semi-annual, or 
quarterly social entertainments, as a part of their regu- 
lar work." 

With this recommendation the Board is in hearty ac- 
cord, and if carried out believes it would tend very ma- 
terially to cement the county societies together in closer 
and more fraternal harmony. 

Fifth Recommendation. 

Without quoting the President's fifth recommenda- 
tion at length, the Board undertakes to state it as fol- 
lows, believing that all of the points it embodies are in- 
cluded : 

He prox>ose8 that county boards of examiners be abol- 
ished, and that one State Board, before which all appli- 
cants must appear, be created, said Board to be com- 
posed of members of the different sects of medicine in 
the State, in proportion to the numerical strength of 
the organized bodies or State Associations of such sects. 

He further proposes that all applicants belonging to 
any irregular sect shall be examined in anatomy, physi- 
ology, pathology, chemistry, symptomatology, and diag- 
nosis, and that all applicants belonging to the regular 
system of medicine shall, in addition to the preceding 
branches, be examined in the practice of medicine, sur- 
gery, obstetrics, and gynecology. 

One other provision is included, namely, that appli- 
cants who propose to practice "some particular or spe- 
cial system" shall be examined by those "familiar with 
the particular method," including "the treatment of dis- 
eases according to his school or system." 

This recommendation covers a wide scope, and to deal 
with it exhaustively would require a very lengthy dis- 
cussion. 

Were the recommendation endorsed by this Asso- 
ciation, it would be necessary, in order to put it into ope- 
ration, to apply to the General Assembly for a radical 



REPORT OF THS BOARD OF 0BK60R8. 37 

reconstruction of the law regulating the practice of 
medicine in the State. The Board has the authority of 
the President for pronouncing this an unwise and dan- 
gerous experiment, he having so expressed himself in an 
argument on the floor of the Association last year. The 
Board coincides with this view, and is of the opinion 
that the danger pointed out would, alone and unsuj)- 
ported, be a sufficient argument against the adoption of 
the recommendation in question. 

So far as abolishing county boards of examiners is 
concerned, that question has been discussed at consider- 
able length on previous occasions, and the verdict of the 
Association has always been that such a course would 
be unwise and impolitic. It scarcely seems necessary 
to enter into an elaborate argument, here and now, in 
defense of our system in this respect. 

We turn, therefore, to the consideration of the mem- 
bership of the proposed State Board, which the Presi- 
dent recommends shall take the place of the present 
State Board and of the county boards. He says : 

"This Board should contain representatives, acccord- 
ing to the numerical proportion of the so^alled schools 
of medicine." 

A little analysis will show how utterly impracticable 
it would be to constitute a State Board of Examiners 
upon such a plan. 

Were it undertaken, the first step would be to fix a 
unit of representation on the Board, that is to say, the 
sect or school of medicine in the State having the small- 
est numerical strength would be entitled to one mem- 
ber, and starting from that basis, all other schools to 
their pro rata share of members. On such a board the 
regulars, the homeopaths, the eclectics, the Thomson- 
ians, the osteopaths, the hydropaths, the magnetic 
healers, the vitapaths, those adhering to a belief in the 
wonderful virtues of the electropoise, and, finally, the 
Christian Scientists would claim membership. In all 
probability this list would be continually added to, 
and whenever an addition occurred the basis of repre- 
sentation on the Board would require to be re-adjust- 
ed. But, let us make some figures in order to see 
clearly how the plan would work. 



§8 THE MEDICAL A8S00tATI0K OP ALABAMA. 

Supi)ose the Btate Organization of the smallest 
school or sect of medicine in the State should number 
ten members, such school would be entitled to one 
member of the Examining Board; a school having a 
numerical strength of fifty would be entitled to five 
members; and, in this projwrtion, through the differ- 
ent schools, up to the largest. 

The President tells us that there are 930 regular 
physicians belonging to the county societies, and a 
total of 1,600 regular physicians in the State. Adopt- 
ing the former figures, that is 930, and applying the 
basis fixed upon to that number, it will be seen that 
the regular profession would be entitled to 93 mem- 
bers on such a State Board of Examiners as that pro- 
posed by the President, and should all of the 1,600 
regular physicians in the State become members of 
their respective county societies, and, thus, members 
of the State Association, the regular profession would 
be entitled to one hundred and sixty members. 

It is at once evident that a board so constituted 
would be utterly impracticable and would fall to pieces 
by its own weight. 

Let us continue the analysis somewhat further. 

The President's plan provides that all applicants 
for license belonging to any irregular sect or school of 
medicine shall be examined "in anatomy, physiology, 
pathology, chemistry, symptomatology, and diagnosis." 
But, the pertinent question arises : How could the mem- 
bers of the Board belonging to the school of magnetic 
healers, that of the Christian Scientists, or the believ- 
ers in the electropoise, for instance, take part in hold- 
ing examinations on the above named subjects, they 
knowing nothing of said branches themselves, and main- 
taining that such knowledge is unnecessary to the suc- 
cessful treatment of disease. Yet, according to the 
recommendation of the President, representatives from 
these sects, as of any other sect that might arise, must 
hold positions on the Board, else one other essential 
of his plan could not be carried out, namely, the ex- 
amination of each applicant for license in the "treat- 
ment of disease according to his school or system." 
That is to say, an osteopath must be on the board to 
examine all applicants w^ho propose to practice that 



REPORT OF THE BOARD OF 0EN80R8. 89 

system in the application of massage ; a magnetic healer 
mu«rt be there to examine all applicants who intend to 
treat disease according to that system; a believer in 
the electropoise must be there to ascertain whether ad- 
herents of that system understand how to tie the magic 
string around the legs of patients which is guaranteed 
as a sovereign remedy for diseases of every kind. There 
would be no escape from placing such representatives 
on the first board created in accordance with the Presi- 
dent's views. 

Think of admitting to membership on a State Board 
examiners who, not only are ignorant of the great fun- 
damental sciences upon which all rational therapeu- 
tics rest, but who repudiate such knowledge as un- 
necessary! Would it not be an insult for a regular 
physician — one who had thoroughly equipped himself 
by years of arduous and extensive study for the scien- 
tific treatment of disease — ^to appear before a board 
of examiners composed, in part even, of such mem- 
bers? Would not the creation of such a board prove 
demoralizing, by discouraging competent and am- 
bitious young men from becoming learned in the science 
and art of healing, and thus result in placing the lives 
of the sick and injured in the hands of the charlatans, 
quacks, and imi)ostors? 

Further, in the recommendation is embodied the prop- 
osition that the scope of the examination of regulars 
and irregulars shall differ, that is, that irregulars shall 
be examined in anatomy, physiology, pathology, chem- 
istry, symptomatology, and diagnosis, and that, in ad- 
dition to these branches, regulars shall be examined in 
the practice of medicine, surgery, obstetrics and gynsB- 
cology. 

In other words, a shorter examination is proposed 
for irregulars, and a longer for regulars. 

When our law r^ulating the practice of medicine 
first went into operation, the State Board, acting under 
the authority granted it of regulating examinations, 
the subjects thereof, etc., provided a longer examina- 
tion for regulars and a shorter one for irregulars. In 
the former, ten branches were included; in the latter, 
only four. 



90 THE MEDICAL ABBOCIATION OF ALABAMA. 

After f9ome jearo of application of this rule, it was 
found that fiome regular phyBicians, who intended to 
practice the regular systeniy would, for obvious reasons, 
apply for the shorter examination, and, if successful 
in obtaining license, would then practice the regular 
system. The manifest injustice and dishonesty of this 
course led to the adoption of the present rule, namely, 
one requiring that all applicants shall be examined upon 
the same branches, ten in number, but that materia medi- 
ca and therapeutics shall be entirely excluded from the 
examination. The obvious reason for this rule was that 
a regular physician could not examine an irregular one 
upon his remedial agents, or upon his method of treat- 
ing diseases. 

This change prevented the evasion of the law by dis- 
honest applicants, and clarified the entire subject of ex- 
aminations. 

The President now proposes that an irregular be ex- 
amined ^^in the treatment of disease according to his 
school or system." It is not clear whether he proposes 
that regulars be examined in the treatment of disease, 
but as he enumerates ^Tractice of Medicine" as one 
of the branches upon which they must be examined, it 
is to be inferred that he does mean for them to be ex- 
amined in the treatment of disease, also . 

As has been said, the elimination, years ago, of 
materia medica and therapeutics from the examination 
constituted an important advance in the selection of 
subjects for examination. The truth is, there is no 
absolute standard of therapeutics. For instance, two 
regular physicians may graduate from the same col- 
lege and own precisely the same medical books, and yet 
may differ as to the treatment of diseases. How physi- 
cians will treat their patients must be left to their judg- 
ment after having prepared themselves for exercising 
judgment about such matters. If therapeutics were a 
subject for examination, two examiners might differ 
very widely in their valuation of the same answer, one 
(ronsidering it, according to his view, a perfect answer, 
whilst the other might consider it absolutely worthless. 
The justice of excluding the subject of therapeutics 
from all examinations is too apparent to need further 
discussion. Both equity and policy dictate that it be 



REPORT Of THE BOARD OF 0BN80R6. QX 

excluded from the examination of all irregulars. The 
President, however, proposes that the subject be re- 
introduced into examinations, which proposition does 
not meet with the approval of this Board. 

Without continuing further the analysis of the Presi- 
dent's fifth recommendation, the Board advises that it 
be not endorsed. 

Sixth Recommendation. 

The President's closing recommendation is that ef- 
forts be continued to raise funds for erecting a monu- 
ment to our deceased leader, Jerome Cochran. With 
the splendid and eloquent tribute the President pays 
to the memory of the man who created our system of 
organization and made it what it is, we are in full and 
faithful sympathy and trust that the fervid appeal he 
makes will so fire the hearts of the members of this 
Association that they will not relax their efforts until 
a monument is erected worthy of the dead, and credit- 
able to the living, and that shall proclaim to posterity 
the high value we place upon the services Jerome Coch- 
ran rendered to the profession and the people of this 
State. 

Reports of the Vice-Presidents. 

The reports of the vice-presidents show that they 
have felt deeply interested in their work, and that they 
have spared no effort to make it a success. They are 
richly entitled to that credit always due for unselfish 
and laborious work faithfully performed. 

Acting ux>on a suggestion contained in the report of 
the senior vice-president, the Board recommends that 
the sum of twenty-five dollars be set aside for each of the 
vice-presidents, to meet necessary expenses incurred in 
correspondence and in the performance of their duties in 
other re6i)ects. The Board is aware that these sums are 
small, being intended merely to meet some of the inci- 
dental expenses, but in fixing them the Board adheres 
to the policy which has prevailed in this Association 
since its organization, namely, to expect that a large 
amount of its work shall be done without the hope of 
receiving other reward therefor than the consciousness 
of having faithfully labored to uphold the dignity and 
to extend the usefulness of the profession. 

The Board recommends that the vice-presidents 
shall famish vouchers^ along with their aimnal reports^ 



92 THE MEDICAL AB800IATI0N OF ALABAMA. 

for all expenditures made nnder this appropriation, 
whether a part only of the amount be expended or the 
whole. 

The Report of the Secretary and the Book of the Rolls. 

The report of the Secretary has been rendered in due 
order, but, as explained in the report, the books are not 
here, the reason being that the case m which they have 
heretofore been transported to the meetings of the As- 
sociation has become so worn that it does not admit of 
the books being safely shipped in it. The Secretary 
did not conclude that the case was unsafe until it was 
too late to remedy the difficulty, hence the absence of 
the books at this meeting. The Board recommends 
that the Secretary be authorized to purchase another 
case or container for the books. 

Report of the Committee of Publication. 

The Committee of Publication reports great delay in 
the appearance from the press of the last volume of 
Transactions, and gives some of the reasons that led 
to so much delay. Profiting by the experience acquired, 
the Committee will be expected, by the Board and the 
Association, to succeed in procuring the publication 
of the next volume more promptly than the last was 
published. 

Report of the Treasurer and the Book of Accounts. 

The Board reports that the Auditing Committee exam- 
ined the report of the Treasurer and the Book of Ac- 
counts, and found them correct, and recommends that 
they be approved. 

The Accounts of the State Health Officer. 

Owing to the calls which the State Health Officer re- 
ceived within the pa»t two weeks to visit various parts 
of the State, it proves to be impossible to make a full 
statement of his accounts at this time, for which the 
Health Officer expressed his regrets. 

The Board recommends to the Association that the 
membera of the Board residing in Montgomery be ap- 



REPORT OF THE BOARD OF 0ENB0R8. 93 

pointed a committee to examine the acconntB of the 
State Health Officer, as 60on as can be done, and that 
said committee have power to act, that is, to approve 
or disapprove them, and that said action be incorpor- 
ated as a part of this report and printed in the forth- 
coming volume of Transactions. 

Revision of the Minutes of 1900. 

We are glad to be able to report that no errors occur 
in the Minutes of last year. 

In other parts of the volume, typographical errors are 
tolerably numerous, but in most instances it is easy for 
the reader to apply the correction. The most essential 
errors are pointed out in a table of errata. 

The way in which these typographical errors occurred 
was explained- in the report of the CJommittee of Pub- 
lication. Profiting by the experience of last year in 
having printing done with a linotype, doubtless efforts 
will be made to avoid similar trouble in the future. 

Delinquent County Societies. 

The number of county societies found totally delin- 
quent (10) at the last meeting of the Association, was 
in excess of the usual average, due, no doubt, to the 
serious interruption of travel caused by the heavy floods 
that prevailed just before and at the time of the meet- 
ing. 

The societies reported as totally delinquent are: 

Blount, Clarke, Covington, DeKalb, Franklin, Greene, Lauder- 
dale, Morgan, Pickens and Wilcox. 

Whilst some of these counties have been on the delin- 
quent list continuously for several years past, others 
were there, doubtless, for the reason already stated. 

Numerous letters have been written tx> the officers 
and members of the delinquent societies, with the hope of 
stimulating them to a full compliance with the consti- 
tutional obligations of their respective societies at this 
meeting. 

New Edition of the Book of the Rules and New 

Charters. 

Circumstances have rendered it both impossible and 
impolitic to publish a new edition of the Book of the 



94 THE MEDICAL ABBOOIATION OF ALABAMA. 

Rules, the r^tsons for which need not, perhaps, "be 
stated at length here. 

The same explanation applies, in the main, to the 
failure ta furnish the county societies with new char- 
ters. 

The Board recommends that the authority to revise 
the Book of the Rules and to issue new charters to 
county medical societies, heretofore granted, be con- 
tinued. 

Visit to Washington. 

The Board reports that in May of last year the State 
Health Officer deemed it wise to make a visit to Wash- 
ington, in order to obtain a hearing before a Senate 
Committee having under consideration a bill to en- 
large the quarantine iK)wers of the Marine Hospital 
Service. 

After arriving at Washington he procured a copy of 
the bill. Upon reading it, he saw grave objections "Uiere- 
to, the objections applying more particularly to 
the first section. Along with a number of other health 
officials, representing various coast cities, from Boston 
to New Orleans, he had a hearing before the Committee, 
consisting of seven Senators, with Vest, of Missouri, as 
chairman. 

The first health official who addressed the Commit- 
tee (Dr. Goode, of Mobile) endorsed the bill in its en- 
tirety, expressing himself in favor of conferring upon 
the Marine Hospital Service not only all the power 
asked for in the bill, but more. 

The State Health Officer obtained the second hearing, 
and endeavored to jwint out to the Committee the very 
serious objections to the first section of the bill. 
To the other sections there were no serious objec- 
tions to be made. Indeed, some of the sections were 
entirely proper, and in the direction of promoting the 
sanitary interests of the country. 

A number of the other health officers present ad- 
dressed the Committee, all of whom opx)osed the en- 
actment of the bill into law, especially the first section. 

Subsequently, the bill passed the Senate, but with 
the first section entirely stricken out. 



REPORT OF THE BOARD OF 0BNB0R8. 95 

Jails and Poor Houses. 

At the meeting held in Mobile, in 1899, a movement 
was inaugurated to ascertain the condition of the jails 
and poor houses of the State, and also, the adequacy 
or not of the provisions made for supplying the inmates 
with food and physical comforts. 

A circular letter, containing a series of interroga- 
tories calculated to elicit the needed information, was 
sent out to the health officers of all the counties in the 
State. Many of the reports were ready to be submitted 
at the last meeting of the Association, but preferring 
to wait until the report could be made as complete as 
possible, they are now submitted. 

Jail Reports. 

After examining and comparing the reports received, 
we have classified the jails under three heads, as fol- 
lows: 

1. Jails reported in good sanitary condition, and 
inmates treated, in all reBi)ects, humanely. 

2. Jails reported in *airly good sanitary condition, 
and inmates fairly well treated. 

3. Jails reported in bad eanitary <K>ndition, and 
inmates inadequately provided for. 

Under the first head we place the jails of the follow- 
ing counties: 

Autauga, Baldwin, Barbour, Calhoun, Chambers, Cherokee, Cle- 
burne, Conecuh, Crenshaw, Dale, Dallas, DeKalb, Escambia, Etowah, 
Fayette, Franklin, Hale, Jefferson, Lamar, Lawrence, Lee, Marengo, 
Marshall, Mobile, Monroe, Montgomery, Pike, Randolph, Russell, 
Shelby, Sumter, Tuscaloosa, Washington, Winston. Total, 34. 

Under the second head^ the following : 

Macon, Perry, St. Clair. Total, 3. 

Under the third: 

Clay. Total, 1. 

Poor House Reports. 

Fifty-six reports were received. After examining 
and comparing them we have classified them as follows : 



96 THE MEDICAL A8B00IATI0N OF ALABAMA. 

(a) — Counties that provide houses for their poor : 

Barbour, Bibb, Blount, Bullock, Butler, Calhoun, Cherokee, Chilton, 
Clarke, Clay, Coffee, Conecuh, Coosa, Crenshaw, Elmore, ISscambia, 
£}towah, Fayette, Greene, Hale, Henry, Jackson, Jefferson, Lawrence. 
Lauderdale, Lee, Limestone, Macon, Madison, Marion, Marshall, Mo- 
bile, Monroe, Montgomery, Perry, Pickens, Pike, Randolph, Russell, 
Shelby, Sumter; Talladega, Tallapoosa, Tuscaloosa, Washington. To- 
tal. 45. 

(6) — Counties that do not provide houses for their 
poor: 

Baldwin, Chambers, Choctaw, Cleburne, Cullman, Dale, Dallas, 
DeKalb, Marengo, St. Clair, Winston. Total, 11. 

Of the counties that do provide houses we make the 
following classification: 

1. Cou:nties that provide comfortable houses and 
supply the inmates with a;bundant food, bedding, and 
clothing : 

Barbour, Blount, Bullock, Butler, Calhoun, Cherokee, Chilton, 
Clarke, Clay, Coffee, Conecuh, Coosa, Crenshaw, Elmore, Greene, 
Hale, Jefferson, Lauderdale, Lee, Limestone, Madison, Marion, Mar- 
shall, Mobile, Monroe, Perry, Pickens, Pike, Randolph, Shelby, Sum- 
ter, Talladega, Tallapoosa, Tuskaloosa. Total, 34. 

2. Counties that provide fairly comfortable houses 
and supply the inmates fairly well with food, clothing 
and bedding: 

Bibb, Escambia, Etowah, Fayette, Henry, Lawrence, Washing- 
ton. Total, 7. 

3. Counties that do not provide comfortable houses 
and do not supply the inmates with adequate food, 
clothing and bedding: 

Jackson, Macon, Montgomery. Total, 3. 

4. Counties that do not provide houses for their 
poor, bitt care for them otherwise, — that is, by placing 
them under the charge of persons, paying monthly 
allowance for them, etc. Of these counties, the follow- 
ing named report the arrangement satisfactory, and that 
the poor are properly cared for : 

Baldwin, Chambers, Choctaw, Cleburne, Cullman, Dale, Dallas, 
DeKalb, Marengo, St Clair, Winston. Total, 11. 



REPORT OF THE BOARD OF CENSORS. 97 

It will be seen that whilst the jails and poor houses, 
in a large majority of the counties, are reported in 
good sanitary condition and the inmates well provided 
for, some are reported in opposite condition. 

In counties of the latter kind the committees of pub- 
lic health and the county health officers should make 
vigorous efforts to have the conditions improved. As 
one of the evidences of advancing civilization, along 
with which advance all authorities in charge of pris- 
ons should endeavor to keep pace, the sanitary and hy- 
gienic surroundings of those who are undergoing penal 
servitude, or are objects of public charity, should 
be maintained at such standards of comfort as to admit 
of no criticism. 

Ordinance Enacted La^t Year. 

At the last meeting of the Association the following 
ordinance was eniacted : 

"Be it ordained by the Medical Association of the State of 
Alabama, That any member of a County Board of Bzaminers who 
may be officially connected with the college of which any appli- 
cant who may appear before the board for examination is a gradu- 
ate, or who is related by blood or marriage to such applicant, shall 
be disqualified from participating in the examination of such ap- 
plicant 

The place of such member of the board for such examination 
shall be temporarily supplied by the remaining members of the 
board from among the reputable and qualified members of the so- 
ciety of which such board is the creature." 

Whilst the equity of this ordinance cannot be ques- 
tioned, the l^ality of it has been questioned, on the 
ground of its being in violation of the Constitution of 
the Association. 

The Senior Censor has obtained legal advice on this 
point, and whilst the attorney whom he consulted is 
not clearly of the opinion that the ordinance is in vio- 
lation of the Constitution, yet, there being a doubt, the 
attorney advises that the ordinance be declared inoper- 
ative until the Constitution can be so amended as to 
remove all doubt. In order to carry out this policy 
the Board recommends: 

1. The adoption of the following resolution : 



98 THE MEDICAL ASSOCIATION OF ALABAMA. 

Resolved, That an ordinance adopted at the meeting of this 
Association, held in Montgomery, in 1900, prohibiting any member 
of a college faculty who at the same time is a member of a 
County Board of Examiners from participating in the examination 
for license to practice medicine of any graduate of the college to 
whose faculty said member belongs, and likewise prohibiting any 
member of a County Board of Examiners from participating in the 
examination of an applicant for license related to him either by 
blood or marriage, be declared inoperative until such time as the 
Association may make it operative. 

2. The Board next proposes the following amendment to Article 
70, Section 14, of the Constitution of this Association: 

Insert after the word "members" in the third line the following 
words: The qualifications for membership of which board, and how 
places thereon may be filled, or duties performed, in cases of tempo- 
rary disqualification, sickness, or absence, of regular members, may 
be prescribed, from time to time, by the Association. 

Legislation. 

In accordance with instructions received from this 
body, eflforts were made during the recent session of 
the General A-^embly to procure legislation upon sev- 
eral subjects. Bills were drawn covering these subjects, 
and, upon request, were introduced into the General As- 
sembly by members thereof. We have to report that 
only two out of ten bills thus introduced were enacted 
into law. 

To give a historical account of the causes that led 
to the failure of such a large proportion, and by far 
the most important, of the bills to become la^'S, T^'ould 
require a long story. 

One fact, however, was very forcibly impressed, 
namely, that legislators are but little inclined to con- 
sider or legislate ui)on public health questions. The 
truth is that in a session limited to fifty days, the mem- 
bers of the General Assembly are hard-worked, and 
with the great and growing mass of local legislation 
that engages their attention it is practically impossible 
to find opportunities of so informing them upon public 
health questions demanding legislation as to secure 
their hearty co-operation. The only remedy for these 
difficulties consists in educating the members of the 
General Assembly, in advance of the session, upon such 



REPORT OF THE BOARD OF CENSORS. 99 

public health questions as will be brought to their at- 
tention. TMb can only be done by the resident physi- 
cians of the various counties. They are the constitu- 
ents and friends of the membere, respectively, and, 
therefore, occupy favorable positions for informing and 
interesting them upon such matters. In any effort 
that may be made hereafter to secure legislation, the 
wisdom of employing this method is urged upon the 
members of this Association. 

The two bills enacted into laws were: 

1. A bill increasing by one thousand dollars the SLp- 
propriation for carrying into execution the health laTV'S 
of the State. 

2. A bill referring to the reports of deaths by mid- 
wives. 

The time has arrived for this A-ssociation to assert 
in an open and dignified way its claim to advisory 
authority upon all public health questions. Its record 
is certainly such as to entitle its counsels to respectful 
consideration, both by the people and the law-makers 
of the State, and it can well afford to challenge inves- 
tigation of that record. For more than twenty years 
it has i)er8istently sought to build up a public health 
system intended to prevent, as far as possible, disease. 
Should the advice of its members upon questions that 
preeminently lie in their special domain of thought 
and study continue to be disdained and repudiated, 
self-respect will dictate that such advice be no longer 
furnished, especially, as it is done wholly without re- 
muneration or the expectation thereof. Trusting, how- 
ever, to the final success of a public health system be- 
lieved to be founded upon correct principles, and calcu- 
lated to promote, in very large degree, the sanitary in- 
terests of the people, the members of the Association are 
invoked to continue their efforts to build up the sys- 
tem, until complete success is achieved, or there is no 
longer any prospect of success. 

Of the ten bills bearing upon public health matters 
introduced into the last General Assembly, the one in- 
tended to provide salaries for county health oflftcers 
was by far the most important, and the one to the suc- 
cess of which all others would have been freely sacri- 






100 ^^^ MEDICAL ASBOOIATION OF ALABAMA. 

flced. A salaried health officer, as a salaried sheriff, 
should exist in every county of the State. We must 
never surrender our efforts to secure the passage of a 
bill providing adequate remuneration for such an officer, 
for, perseverance rarely fails to secure an object to which 
ft clings with unyielding tenacity. 

Whilst we failed to secure much of the legislation we 
did want, -we achieved, perhaps, a greater triumph by 
preventing legislation we did not want. 

It is known to many, if not all, of the members of 
this Association that some ten years ago a board, de- 
nominated the Quarantine Board of Mobile Bay, was 
created in violation of one of the fundamental princi- 
ples for which we have been contending for twenty-five 
years, or more, namely, that health and quarantine 
boards should consist exclusively of medical men, and 
should be independent of both political and commer- 
cial domination. The Quarantine Board of Mobile 
Bay is a mixed board, that is, it consists of medical and 
non-medical members or commercial men, the latter 
being largely in the majority. 

The act creating this Board was obtained under pe- 
culiar circumstances, into the history of which time 
does not permit us now to go. However wrongly or 
unwisely created, the Board became an accomplished 
fact, and so remains to the present time. No effort 
has been made by this Association to undo the legisla- 
tion alluded to, chiefly for the reason that the Board 
employed a very experienced medical man as executive 
officer, one to whom great ability in the administration 
of quarantine is conceded. 

With a man of that character in control of the prac- 
tical administration of such quarantine as falls under 
the jurisdiction of the Board, the profession and peo- 
ple of Mobile felt a high degree of security. It must 
be remembered, however, that no one man can live al- 
T^'ays, and, indeed, the medical officer to whom allusion 
is made, has, by reason of ill health, been rendered un- 
fit for duty for some months past, and it is uncertain 
when, if ever, he will be able to resume active adminis- 
trative work. 

It is safe to assert that no man can succeed him who 
will, as a quarantine officer, enjoy the confidence of the 



REPORT 0^ TBE board OP OElfBORS. JQl 

profession and people of Mobile to the same extent that 
he did. An organization that so largely depends upon 
the life or continuance in ofBce of one man is certainly 
not based upon sound principles. 

The jurisdiction of the Quarantine Board of Mobile 
Bay, by the terms of the Act that created it, is con- 
fined to the waters of Mobile Bay. At the recent ses- 
sion of the General Assembly Hon. E. H. Clarke, of Mo- 
bile, introduced a bill which proposed to enlarge the 
jurisdiction and the power of the Board, to an extent 
believed by your State Health Officer to be dangerous. 
The bill reads as follows: 

A BILL 

To be Entitled An Act to Extend and Better Establish, Maintain 
and Regulate the Duties and Authority of the Quarantine 
Board of Mobile Bay. 

Section 1. Be it enacted by the General Assembly of Alabama, 
That the authority of the Quarantine Board of Mobile Bay be and 
the same is hereby extended over all the waters of the Gulf of 
Mexico, including that portion thereof known as Mississippi Sound, 
bordering upon or within this State and over which this State has 
Jurisdiction. 

Sec. 2. Be it further enacted, That the Quarantine Board of 
Mobile Bay be and the same is hereby authorized to cause any 
person or persons upon vessels entering any of the waters within 
the authority of said Board to be detained in Quarantine at the 
place of such entry, or at such other place or places in said waters as 
may be designated by the said Board, for such reasonable time and 
under such regulations as said Board may deem necessary or de- 
sirable for the preservation of the public health; Provided, that 
this section of this Act shall in no wise abridge or impair such 
other powers and authority as are vested in said Board by law. 

Sec. 3. Be it further enacted. That the powers and authority 
vested in said Quarantine Board of Mobile Bay by law shall be 
exercised exclusively by said Board, and shall not be set aside or 
interfered with save by the Governor of this State in the exercise 
of the powers of quarantine vested in him by law for the protec- 
tion of the health of the people of this State. 

Without undertaking to enter upon anything like 
an exhaustive discussion of the bill, some of the i^ient 
objections thereto may be briefly stated. By the terms 



iQ2 ^^^ MEDICAL AB800tAl*l6N OF ALAJ^AMA. 

of the Act creating the Board its jurisdiction is con- 
fined to the waters of Mobile Bay, that is, it guards the 
entrance to the bay, and decides what ships, coming 
from either domestic or foreign ports, shall be per- 
mitted to enter, and upon what terms. Inasmuch as 
ships, in order to reach Mobile, must first en- 
ter the bay and then pass into Mobile river, 
they necessarily come under the jurisdiction of 
the Board of Health of Mobile County before landing 
at the wharves. In the last analysis, therefore, the 
Board of Health of Mobile county can fix the terms 
upon which vessels are permitted to land at the wharves. 
This check has heretofore existed against any unwise 
risks taken by the Quarantine Board of Mobile 
Bay, and has been applied in one or more instances. A 
notable one w^as when a gentleman, then the Mayor of 
Mobile, who had been prominent and infiuential in se- 
curing the legislation that created the Quarantine 
Board of Mobile Bay, appealed to the Board of Health 
of Mobile county to prevent the landing of a steamer, 
believed to be dangerous, which had been permitted to 
enter the bay by the Quarantine Board of Mobile Bay. 
That is to say, one of the very gentlemen who had been 
largely instrumental in securing the legislation which 
created the Board, when confronted by a risk that had 
resulted from its unwise action, appealed to the Board 
of Health of Mobile county to nullify said action, which 
was done. 

The adoption of Mr. Clarke's bill would have entirely 
removed this wholesome check. 

Section 1 of the bill seeks to enlarge the jurisdiction 
of the Board so as to make it extend ^^ver all the 
waters of the Gulf of Mexico, including that portion 
thereof known as Mississippi Sound, bordering upon 
or within this State, and over which this State has 
jurisdiction." 

Now, if the creation of a mixed quarantine board, 
one composed partly of medical and partly of commer- 
cial men, the latter being, in the case under discussion, 
very much in the majority, is wrong in principle and 
dangerous in practice, it must follow that any enlarge- 
ment of the powers of such a board only perpetuates 
and intensifies the virrong already committed. For the 
same reason that judges and jurors are not permitted 



REPORT OP THE BOARD OF CENSORS. 103 

to sit upon cases in which they have a personal inter- 
est, sOy commercial men should not be permitted to 
control in matters of quarantine, lest their judgments 
might be perverted by their commercial interests. It 
is clear, therefore, that the powers of the Quarantine 
Board of Mobile Bay should not be extended, as was 
proposed to be done in the first section of the bill under 
discussion. Many practical reasons might be pointed 
out against such extension of power. One will be men- 
tioned : Suppose a disease should prevail at Scranton, 
Miss., in reference to the diagnosis of which the medi- 
cal officer of the Quarantine Board of Mobile Bay and 
the medical officers representing the city and county 
of Mobile and the State of Alabama should differ, the 
latter declaring the disease to be yellow fever, the for- 
mer declaring it not to be. Under such conditions the 
State of Alabama and the city and county of Mobile 
would very likely declare quarantine against Scranton, 
but the Quarantine Board of Mobile Bay could not, 
with due respect to its medical officer, so declare. With 
the Quarantine Board of Mobile Bay keeping the Ala- 
bama coast bordering upon the Qulf and the waters of 
the Bay freely open to all craft coming from Scranton, 
it would be practically impossible for the State and the 
city and county of Mobile to enforce quarantine 
against Scranton." 

As section 2 of the bill simply enumerates i>owers 
already jxossessed by the Quarantine Board of Mobile 
Bay, it is unnecessary to discuss that section. 

In section 3 of the bill lurked the greatest danger. 
As already said, the orig^'nal Act creating the Quaran- 
tine Board of Mobile Bay restricts the jurisdiction of 
the Board to the waters of the Bay. Had the third sec- 
tion of the bill been enacted into law all checks upon 
possible unwise action on the part of the Quarantine 
Board of Mobile Bay would have been entirely removed, 
save such as, according to the terms of the bill, might 
have been applied "by the Governor of this State in the 
exercise of the i)owers of quarantine vested in him by law 
for the protection of the health of the people of this 
State." 

Suppose an issue as to the admission of a vessel 
should arise betwixt the Quarantine Board of Mobile 
Bay and the Board of Health of Mobile county, the for- 



104 TBE MEt)IOAL ABSOCTATIOK OF ALABAMA. 

mer declaring it safe for the vessel to land at the wharves 
of Mobile, the latter declaring it unsafe, how could 
the dispute be settled? The Ghovernor is in Montgom- 
ery, and therefore far removed from the scene of dis- 
pute, the circumstances of the case are unknown to 
him, and can only be communicated by mail or by repre- 
sentatives of the two conflicting authorities seeking i>er- 
sonal interviews with him, all of which would require 
considerable time. It is obvious, therefore, that delay 
and friction would occur, a condition of things favorable 
neither to the efficiency of quarantine, nor to the promo- 
tion of commerce. 

If Mobile is entitled to a mixed quarantine board for 
the protection of her commerce, then, why are not Sel- 
ma, Brewton, Montgomery, Birmingham, Decatur, and 
every other incorporated town in the State entitled to 
the same kind of a board? Let this condition of things 
prevail and at once the purity and efficiency of our 
quarantine system will be forever destroyed and quar- 
antines declared either upon commercial considerations, 
or under the influence of panic. Both life and commerce 
would be subject to disaster under such a system. 

Many other objections might be presented against 
the bill under discussion, but enough has been 
said to show that had it been enacted into law the 
powers of a board, organized in violation of what we 
believe best for the protection of both the lives and the 
commerce of the people of the State, would have been 
extended to a very dangerous degree. 

Without any instruction from this Association, the 
State Health Officer felt compelled to antagonize the 
bill. Had he failed to do this he would have been un- 
true to the principles for which this Association has 
been contending for a quarter of a century, or more, the 
maintenance of which we believe absolutely essential 
to the creation of a pure, efficient, and permanent pub- 
lic health and quarantine system. 

Mr. Clarke defended the bill with great ability, but 
by means of the valuable aid and cooperation of our 
President, and of the two members of the Board of Cen- 
sors residing in Montgomery, the bill was defeated, an 
achievement that may be pronounced important and 
valuable. 

Inasmuch as the action of the State Health Offlceri 
and of those who cooperated with him in this matter^ 



RSPORT OF tBE BOAJtD OF 0EN80BB. 106 

W€U» taken without instruction from this ABSOciation, 
a report thereof is submitted for approval or disap- 
proval. 

New Ordinances. 

At the last meeting of this Association Dr. B. S. Hill, 
of Montgomery, offered the following resolutions: 

1. Resolved, That registration be the only evidence accepted 
by this Association ot the attendance of a counsellor. 

2. Resolved, That every counsellor be notified of this action 
of the Association. 

The resolutions were referred to the Board of Cen- 
sorS) and the Board, regarding the m'atter as one of im- 
portance, submits the following ordinance to cover it: 

Be it ordained by the Medical Association of the State of 
Alabama, That, in the revision of the roll of counsellors, registra- 
tion, made in strict compliance with the methods prescribed by 
this Association, shall be the only valid evidence of attendance 
upon meetings of this Association. 

As the second resolution provides only for notifica- 
tion, it is deemed unnecessary to embody it in the ordi- 
nance, as, under a rule, elsewhere stated, the publica- 
tion of the above ordinance in the volume of Trans- 
actions will be legal notice to all parties concerned. 

The Board recommends the adoption of the ordinance 
submitted. 

The Board also submits for adoption the following 
ordinances, which explain themselves: 

Be it ordained by the Medical Association of the State of Ala- 
bama,' That the names of all members of this Association whom 
the President desires to appoint as delegates to medical or other 
meetings shall be by him forwarded to the Secretary of the Asso- 
ciation, who shaU, after making a record thereof, return to the 
President for his signature commissions for all delegates so ap- 
pointed, said commissions to be made out on official paper and to 
have the seal of the Association stamped thereon. 

Be it ordained by the Medical Association of the State of Ala- 
bama, That sums of money, amounting to not less than ten nor 
more than twenty dollars, be annually placed in the hands of the 
Secretary and of the Treasurer to be used in defraying small ex- 



106 ^^^ MEDICAL ABBOOtATION OF ALABAMA. 

penses, and that reports, with accompanying vouchers, shall be 
annually rendered by them for such expenditures. 

Be it ordained by the Medical Association of the State of Ala- 
hama. That the publication of the proceedings of this Association 
in the annual volume of Transactions shall constitute legal notice 
to all counsellors, members and delegates, and to all other persons, 
as to the action of the Association upon any matter which has been 
submitted to it, provided, that such notice may be given to coun- 
sellors, members, and delegates by the Senior Censor through spe- 
cial circulars, issued in advance of the publication of the annual 
volume of Transactions, whenever in his Judgment the interests of 
the Association demand such notice. 

Bond of the Treasurer. 

At the last meeting of this Association provision was 
made for requiring the Treasurer to furnish a bond in 
about double the amount of money likely to be under 
his charge at any one time, said bond to be made by an 
indemnity company deemed satisfactory to this Asso- 
ciation, the Association defraying all expenses. 

The Board reports that this duty has not been per- 
formed, but will receive attention in the near future. 

In this connection the Board reports that 
seven hundred and forty-nine dollars and ninety-one 
cents of the funds of the Association were on depos- 
it in the Josiah Morris Bank, Montgomery, at 
the time of its recent suspension. Efforts are being 
made for the bank to resume business, by and mth the 
consent of the depositors. Persons who are thoroughly 
acquainted with the condition of the bank are unquali- 
fiedly of the opinion that the interests of depositors 
will be much better subserved by granting the bank 
time to meet its liabilities than by forcing it into im- 
mediate liquidation. This course is advised by the 
Board, and it is recommended that the Senior Censor 
and the Treasurer be authorized to give their written 
consent for the bank to resume business on the terms 
proposed by it, that is, by the payment, from time to 
time, of fixed per centages of the deposits, the entire 
deposits to be paid by or before the expiration of two 
years. 

Attorney. 

Several years ago Col. Tompkins, who had acted as 
the legal etdviser of this Associationi died^ since whicb 



BEPOBT OF TBE BOARD OP CENSOttS. 107 

time the Afisoriation has had no retained attorney. 
Recently, an arrangement was made with the firm of 
Watts, Troy & Caffey, of Montgomery, to a€t as the 
legal advisers of the Association. It is recommended 
that this action of the Board be approved. 

Dry Tortugas. 

Information has reached the Board that Dry Tortu- 
gas, an island seventy miles distant from Key West, 
Fla., and which for a number of years has been used as 
a refuge and quarantine station for infected ships, has 
been discontinued for such purpose by the general gov- 
ernment, with the intention of converting it into a naval 
station. The health authorities of Florida, believing 
the islund valuable and essential as a quarantine and 
disinfecting station for ships, and not suitable for a 
naval station, are vigorously opposing the proposed 
change. 

Whilst this Board does not possess adequate infor- 
mation upon which to express a positive opinion as to 
the merits of the matter, it has no hesitation in declar- 
ing that there should exist at several points in the Gulf 
of Mexico refuge stations for infected ships sufficiently 
removed from the main land as to prevent all possi- 
bility of endangering places thereon. 

The Board recommends the adoption of the above 
expression of views. 

Inter-State Notification aa to the Presence of Yellow 

Fever. 

A communication referring to the question of inter- 
state notification as to the presence of yellow fever 
was recently received by the State Health Officer from 
Dr. Souchon, President of the Louisiana State Board 
of Health. After due consideration of the subject em- 
braced in the communication, the Board recommends 
that the entire matter be referred to the State Health 
Officer, with power to act in the premises. 

The Board wishes to declare, however, that such an 
agreement should exist among the health authorities 
of the Gulf States, especially, as would guarantee that 
a first case of yellow fever, or one deemed suspicious of 



108 TBS MEDWAL ASSOCIATION OF ALABAMA. 

being such, wherever occurring in their respective ter- 
ritories, would be certainly and promptly announced. 

Resolution as to Working Convicts in Mines. 

The following resolution, offered by Dr. Judson 
Davie, was referred to the Board of Censors : 

Resolved, That the Committee of Public Health of this Asso- 
ciation be and is hereby authorized and instructed to prepare and 
submit to the next General Assembly a bill for such legislation as 
will, in the Judgment of the Committee, effectually prevent such 
convicts as are physically unfit to work in mines from being re- 
quired to perform labor of that kind, and that said Committee shall 
urge the enactment of such bill into law. 

After due consideration of the resolution, the Bofurd 
of Censors recommend that it be not adopted, and 
assign the following reasons for such recommendation : 

The State provides a Board of Convict Inspectors, 
one of whom must be a physician, whose duty it is to 
see that all convicts are humanely and properly treaited. 
Believing it to be the duty of such Board to provide 
that no convict shall be required to work in a mine who 
is physically unfit for such labor, it might with justice 
be regarded as an encroachment upon the prerogatives 
of that Board were this Association to take the action 
contemplated in the resolution, hence the recommenda- 
tion, already stated, that the resolution be not adopted. 

Committee on Sociological Science. 

After consideration of the subject brought to the at- 
tention of the Association in a letter from Dr. R. R. 
Kime, of Atlanta, Qa., Chairman of Tri-State Socio- 
logical Committee (see page 74) and referred to this 
Board, recommendation is made, in compliance with a 
requeert contained in said letter, that a committee of 
three be appointed to coSperate with the Committee of 
the Tri-State Society in furthering the objects set forth 
in Dr. Rime's letter. The Board further recommends 
that the President of the Association, Dr. Cunnigham, 
be one of the members of the Committee, and that he 
be requested to appoint the other two members. 



REPORT OF THE BOARD OF OENBORB. 109 

Letter of Dr. H. G. Perry, Treaa., Referring to Banks of 
Deposit, and to the Case of Dr. A. J. Coley. 

In •compliance with the requeert contained in a letter 
from Dr. H. G. Perry, Treasurer (see page 69), and for 
the reasons therein stated^ the Board recommends that 
the First National Bank of Greensbora, in this State, 
be named as one of the banks of deposit for the funds of 
the Association. 

The explanation which Dr. Perry makes, in the letter 
referred to above, of the clerical error which resulted 
in the name of Dr. A. J. Coley, of Alexander City, being 
dropped from the House of Counsellors last year, is 
deemed satisfactory and justifies the Board in recom- 
mending that the name of Dr. Coley be restored to the 
House of Counsellors, without any loss of rank on ac- 
count of the error, and with an expression of regret that 
such an error occurred. 

Salaries. 

The Board, basing its action upon a suggestion made 
by the President in his message, and also upon its own 
conception of justice and right, unanimously recom- 
mend that the salary of the State Health Officer be in- 
creased to two thousand and five hundred dollars per 
annum. 

The Board also recommends that the salary of the 
Treasurer be increased twenty dollars i)er annum, which 
will make his total salary one hundred and twenty dol- 
lars. 

This recommendation for an increase of salary is 
based upon the fact that under the present system of 
regi9tration the Treasurer performs work which ^ras 
formerly done by an assistant secretary, and for which 
twenty dollars was annually paid. Inasmuch as this 
additional duty increases to that extent the work of the 
Treasurer we deem it fair that his salary shall be in- 
creased to the extent mentioned. 

The Board also recommends that the amount paid 
the clerk in the office of the State Board of Health out 
of the annual appropriation made by the State be in- 
creased from five to seven hundred dollars per annum . 
This addition to the salary of the clerk is rendered pos- 
sible by the recent increase of the appropriation made 
by the State, and is fully justified, not only by the work 
demanded, but by comparison with salaries paid clerks 
in other departments of State work. 



110 THE MEDICAL ASSOCIATION OF ALABAMA. 

The Issuance of the Volume of Transactions. 

In order to facilitate the earlier publication of the 
volume of Traneactiono than has been the case for sev- 
eral years past, and owing to special and temporary 
conditions that exist, the Board recommends that it 
be permitted to expend not more than one hundred dol- 
lars of the funds of the Association in obtaining special 
and competent assistance in preparing for the press the 
matter to appear in the volume. 

Loyalty, to the System of Organization. 

Believing that the utmost harmony in our ranks is 
essential to the fullest achievement of the noble objects 
for which we are striving, the Board deems the time 
appropriate for appealing to the members to carefully 
study and maturely reflect upon the principles incor- 
I)orated in our Constitution. Philosophy of the broadest 
and deepest kind underlies and is interwoven with those 
principles, to understand which requires both study 
and reflection, but, once understood, the judgment as to 
their correctness rests upon the solid rock of conviction, 
and becomes impregnable to every assault. 

A hurried reading of the Constitution is wholly inade- 
quate to enalble one unfamiliar with it to thoroughly 
comprehend the reasons why it was so constructed. It 
must first be studied analytically, so as to clearly sepa- 
rate and set apart the great coordinate features con- 
tained in it, and then it must be studied synthetically, 
so as to appreciate how nicely the coordinate parts have 
been put together to constitute one symmetrical 
and coherent whole. 

It should be the ambition of every member of the 
Association to thoroughly understand, both theoretic- 
ally and practically, our system of organization, and 
then to equip himself with every argument needed to 
repel attacks, come when and how they may. There is 
but one remedy for antagonism to, or lukewarmness in 
support of, the system, and that is to study it until the 
reasons upon which it is founded become clear and con- 
vincing. That such result will follow study does not 
admit of a doubt 



REPORT OF THE BOARD OF 0BNB0R8. m 

Some counsellors and members regard this Associa- 
tion simply as a body of doctors, voluntarily united 
for scientific and social purposes. 

It is this and more. Others r^ard the function of 
examining applicants for license to practice medicine 
as its great dominating feature. It is this, and more. 
Either one of these views is narrow and incomplete, and 
may be compared to looking through a pin hole at a 
broad and beautiful panorama, where one sees a part, 
it may be an important part, but fails to see the whole, 
in its grand and combined proportions. 

As important as the functions mentioned are conceded 
to be, they become dw^arfed when compared with our 
duties and rights as boards of health for the counties 
and the State. Herein resides the function that gives 
us the opportunity of demonstrating the usefulness and 
beneficence of our system of organization, and the 
promptness with which it may be set into operation 
whenever an emergency demands. 

We would not be understood as insisting that counsel- 
lors and members axe not entitled to entertain their own 
ideas as to principles, plans, and policies; on the con- 
trary, we announce that they are, but, should they dif- 
fer as to the estalblished principles and avowed plans 
and policies of the Association, it is their right and 
their duty to "come upon the floor of this Association 
and proclaim and defend their views in open session. 
When the matter has been discussed and settled, all 
should in good faith accept the decision as emanating 
from the supreme arbiter of our differences. 

By living up to this proposition and by thoroughly 
informing ourselves as to the merits of our system, we 
may press forward in the field of sanitary work, feeling 
assured that the future holds in store for us a rich re- 
ward of useful achievement. When that good time 
comes we will all be thoroughly harmonious in spirit 
and effort, and intensely loyal to the cause we have 
helped to establish upon a solid foundation. 



112 THE MEDICAL AB800IATI0N OF ALABAMA. 

PART II.— EXAMINATIONS BY THE STATE BOARD FOR 
LICENSE TO PRACTICE MEDICINE. 

mOM MARCH 81, 1900, TO MABOH 81, 1901. 

Total number examined 18 

Number granted certificates 6 

Number refused certificates 7 

Percentage of rejections 68.82 

Number of graduates examined 11 

Number of graduates granted certificates 6 

Number non-graduates examined 2 

Number non-graduates granted certificates 

f 

The examinations were as follows: 

Jackson Pabk FnxDS (colored), Meharry, 1900. Certificate re- 
fused. 

Hekbt Mabckllus Mabtin, Jr., University of Virginia^ 1899. 
Certificate granted. 

HEifBT Graham Sellers, Vanderbllt, 1900. Centlficate refused. 
Appeal from Jefferson County Board. 

LocHLm MmoR Whyn, Tulane, 1900. Certificate granted. 

Benton McMillan Hall, Tulane, 1900. Certificate granted. 

Charles Amos Plains (colored), Meharry, 1900. Ortlficate 
granted. 

Alfred Flournot Origos, Atlanta Medical CJollege, 1895. Cer- 
tificate granted. Appeal from Jefferson County Board. 

Oscar Wilkinson, Tulane, 1896. Certificate refused. | 

Asa Elwyn Baixard, non-graduate, Pulte, three courses. C!er- i 

tlficate refused 

RosEBT Leon Hill (colored), Howard Medical Ck>Ilege, 1897. 
Certificate refused. Second examination. 

Philip Kino Norman, non-graduate. Certificate refused. 

Percy Hogan Woodhall, University of NashylUe, 1896. Cer- 
tificate granted. 

Ellis Andrews Dale (colored), Cleveland Homeopathic Medi- 
cal College. 1900. Certificate refused. 



REPORT OF THE BOARD OF OENBORB, H^ 

EXAMINATION PAPERS ACCOUNT. 

1900-1901. 

Db. W. H. Sandebs, SnnoB CnrsoB, M. A. S. A., 

In account with 

' The Btate Medical AaeociatUm, 

DEBfTB. 

To balance on hand from last year |149 50 

Cash for examination papers and certificates 266 00 

Cash returned by State Board Health account, (borrowed 
laet year) Ill 70 



To total receipts $627 20 

Cbbditb. 

By cash to Ed. C. Fowler ft Co., two boxes seals for cer- 
tificates I 75 

D. Pope, 100 tin tubes for certificates 22 50 

T. FitzwiUlam ft Co., certificates 15 00 

Expressage on certificates 40 

John L. Cobbs ft Co., ribbon for certificates 5 00 

T. Fitzwilliam ft Co., certificates 8 50 

Expressage on certificates 55 

Expressage on 7 packages examination papers. ... 3 65 

D. Pope, 100 tin tubes 22 50 

Expressage on examination papers 65 

Expressage on examination papers 45 

Expressage on examination papers 1 45 

John L. Cobbs ft Co., ribbon for certificates 5 00 

I^rown Printing Co., examination paper blanks, 

etc 120 50 

T. Fitswilllam ft Co., certificates 15 00 

Postage on examination papers and certificates. ... 33 54 

Expressage on examination papers from Mobile.. 40 

Expressage on examination papers from Tuscaloosa 65 

Loaned State Board of Health account 237 80 

By total expenditures |493 79 

8 



114 ^^^ MBDIOAL AB800IATI0N OF ALABAMA. 

RB0AFITUI.ATIOir. 

To total receipts April 1. 1900, to April 1. 1901 |527 20 

By total expenditures April 1, 1900, to April 1, 1901 493 79 

To balance on hand I 2t3 41 

The undersigned, appointed Special Auditing Committee, have 
examined this account and find the same correct 

W. M. WiLKXBSON, M. D. 

Glenn Andbbws, M. D. 

THE BOOK OP THE RULES ACCOUNT. 

April 1, 1900, to April 1, 1901, 

To balance on hand from last year |16 24 

Cash for six copies Book of the Rules at 50c 3 00 

To total receipts |19 24 

By postage on 15 copies Book of the Rules 1 80 

To balance on hand |17 44 

Note — Eleven copies of the Book of Rules were distributed 
gratia, 

EXAMINATIONS BT THE OOUNTT BOARDS FOB LIGENSB TO PBAOTIGB 

MBDIOINB. 

1900-1901. 

Total number examined 133 

Number granted certificates 120 

Number refused certificates 13 

The applicants were graduates of the following colleges: 

Medical College of Alabama 29 successful 28, rejected 1 

Vanderbilt Medical College 18 successful 14, rejected 4 

Birmingham Medical College 12 successful 12, rejected 

University of the South 9 successful 9, rejected 

Chattanooga Medical College 9 successful 8, rejected 1 

Memphis Hospital Med. Col 8 successful 8, rejected 

University of Nashville 7 successful 6, rejected 1 

Tulane Medical College 6 successful 6, rejected 

University of Virginia 4 successful 3, rejected 1 

Mliharry Medical College 6 Baoceasfal 4, rejected 1 



REPORT OF THE BOARD OF CENSORS. 



116 



Grant Uniyersity 

Golumbla Medical College 

Leonard Medical College 

Montezuma Medical College 

Baltimore Medical College 

Uniyerftity of Georgia 

Barnes Medical College 

Uniyersity of Tennessee 

Georgia Electic Med. Col 

Johns Hopkins 

Atlanta Medical College 

Jefferson Medical College 

College Phys. tt Surg. N. T 

Uniyersity of Pennsylyania 

Uniyersity City New York 

Georgia College Med. ft Surg. . . . 

Denyer Medical College 

Herring Medical College 

St Louis Medical College 

New Orleans Uniyersity 

Atkinta Col. Phys. ft Surg 

LoulsyiUe Medical College 



2 
2 



successful 
successful 
successful 
successful 
successful 
successful 
successful 
successful 
successful 
successful 
successful 
successful 
successful 
successful 
successful 
successful 
successful 
successful 
successful 
successful 
successful 
successful 



2, rejected 

2, rejected 

1, rejected 

1, rejected 

1, rejected 

1, rejected 

1, rejected 

2, rejected 
1, rejected 
1, rejected 
1, rejected 1 
1, rejected 
1, rejected 
1, rejected 
1, rejected 
1, rejected 
1, rejected 
1, rejected 
0, rejected 1 
0, rejected 1 

0, rejected 1 

1, rejected 



The examinations were as follows: 

Autauga County Board — Hallett Webster Thompson, M. D., Tu- 
lane, 1900. Ceitiflcate granted. 

Elbert Horton Downs, M. D., Chattanooga Medical College, 1900. 
Certificate granted. 

John Edward Wilkinson, Jr., M. D., Uniyersity of South,1900. 
Certificate granted. 

Barbour County Board — ^William P. McDowell, M. D., Medical 
College Alabama, 1900. Certificate granted. 

Christopher Hugh McDonald, M. D., Medical College Alabama, 
1900. CeiUficate refused. 

Baldufin County Board — ^No examinations reported. 

Bihh County Boar(^— Albert Milton Wooley, M. D., Medical Col- 
lege Alabama, 1900. Certificate granted. 

Charles P. Martin, M. D., Vanderbilt, Certificate granted. 

John Harrison Owens, M. D., Memphis College, 1899. Certificate 
granted. 

William Battle Bunltin, M. D., Memphis Hospital Medical Col- 
lege, Certificate granted. 



114 ^^^ MEDICAL A8B00IATI0N OF ALABAMA. 

Rboafituultion. 

To total receipte April 1, 1900, to April 1. 1901 $527 20 

By total expenditures April 1. 1900, to April 1, 1901 493 79 

To balance on hand I 33 41 

The undersigned, appointed Special Auditing Committee, have 
examined this account and find the same correct 

W. M. WiLKEBSON, M. D. 

Olenn Andrews, M. D. 

THE BOOK OF THE RULES ACCOUNT. 

ApHl 1, 1900, to ApHl 1, 190L 

To balance on hand from last year $16 24 

Cash for six copies Book of the Rules at 50c 3 00 

To total receipts |19 24 

By postage on 15 copies Book of the Rules 1 80 

To balance on hand 117 44 

Note — Eleven copies of the Book of Rules were distributed 
gratis. 

EXAMINATIONS BT THE COUNTY B0AB08 TOB LICENSE TO PBACTIGE 

MEDICINE. 

1900-1901. 

Total number examined 133 

Number granted certificates 120 

Number refused certificates 13 

The applicants were graduates of the following colleges: 

Medical College of Alabama 29 successful 28, rejected 1 

Vanderbilt Medical College 18 successful 14, rejected 4 

Birmingham Medical College. ... 12 successful 12, rejected 

University of the South 9 successful 9, rejected 

Chattanooga Medical College 9 successful 8, rejected 1 

Memphis Hospital Med. Col 8 successful 8, rejected 

University of Nashville 7 successful 6, rejected 1 

Tulane Medical College 6 successful 6, rejected 

University of Virginia 4 successful 3, rejected 1 

Mitliarry Medical College 6 saccessful 4, rejected 1 



REPORT OF THE BOARD OF OENBORB. 



116 



Grant Unlyeraity 

Columbia Medical College 

Leonard Medical College 

Montezuma Medical College 

Baltimore Medical College 

Univer&ity of Georgia 

Barnes Medical College 

University of Tennessee 

Georgia Electlc Med. Col 

Johns Hopkins 

Atlanta Medical College 

Jefferson Medical College 

College Phys. ft Surg. N. Y 

University of Pennsylvania 

University City New York 

Georgia College Med. ft Surg. . . . 

Denver Medical College 

Herring Medical College 

St. Louis Medical College 

New Orleans University 

Atlanta Col. Phys. ft Surg 

Louisville Medical College 



2 


successful 


2, 


rejected 


2 


successful 


2, 


rejected 




successful 




rejected 




successful 




rejected 




successful 




rejected 




successful 




rejected 




successful 




rejected 




successful 




rejected 




successful 




rejected 




successful 




rejected 




successful 




rejected 1 




successful 




rejected 




successful 




rejected 




successful 




rejected 




successful 




rejected 




successful 




rejected 




successful 




rejected 




successful 




rejected 




successful 


0, 


rejected 1 




successful 


0. 


rejected 1 




successful 


0, 


rejected 1 




successful 


1, 


rejected 



The examinations were as follows: 

Autauga County Board — Hallett Webster Thompson, M. D., Tu- 
lane, 1900. Ceiitiflcate granted. 

Elbert Horton Downs, M. D., Chattanooga Medical College, 1900. 
Certificate granted. 

John Edward Wilkinson, Jr., M. D., University of South,1900. 
Certificate granted. 

Barhour County Board — ^William P. McDowell, M. D., Medical 
College Alabama, 1900. Certificate granted. 

Christopher Hugh McDonald, M. D., Medical College Alabama, 
1900. Certificate refused. 

Baldwin County Board — ^No examinations reported. 

Bibh County Boar<f— Albert Milton Wooley, M. D., Medical Col- 
lege Alabama, 1900. Certificate granted. 

Charles P. Martin, M. D., Vanderbllt, Certificate granted. 

John Harrison Owens, M. D., Memphis College, 1899. Certificate 
granted. 

William Battle Bunitin, M. D., Memphis Hospital Medical Col- 
lege, Certificate granted. 



IXg THE MEDICAL A8800IATI0N OF ALABAMA. 

Blount County Board — ^James Clinton Moore, M. D., Unlyersity 
of Nashyille, 1900. Certificate granted. 

James Edward Leach, M. D., University of NashTllIe, 1900. 
Certificate granted. 

Jesse Brown, M. D.. Memphis Hospital Medical College, 1900. 
Certificate granted. 

Joseph Cobb Walker, M. D., University Nashville, 1900. Cer- 
tificate granted. 

Bullock County Board — George Martin Guthrie, M. D., Medical 
College of Alabama, 1900. Certificate granted. 

Anderson Milton Williams (colored), M. D., Leonard Medical 
College, 1900. Certificate granted. 

James L. Bowman, M. D., University of Virginia, 1897. Certi- 
ficate granted. 

Butler County Board — No examinations reported. 

Calhoun County Board — ^Amzi Jones, M. D., Vanderbilt, 1900. 
Certificate granted. 

Shelton Theodore Meharg, M. D., Memphis Hospital Medical 
College, 1900. Certificate granted. 

Eber Austin Pruitt, M. D., Medical College of Alabama, 1900. 
Certificate granted. 

Chambers County Board — No examinations reported. 

Cherokee County Board — Ira Cheleous Ballard, M. D., Chatta- 
nooga Medical College, 1900. Certificate granted. 

William Sparks McElrath, M. D., Memphis Hospital Medical 
College, 1900. Certificate granted. 

Chilton County Board — ^W. E. Prescott, M. D., Birmingham 
Medical College, 1900. Certificate granted. 

M. F. Parnell, M. D., (college and date of graduation not given). 
Certificate granted. 

Virgil Ogilver Campbell, M. D., Birmingham Medical College, 
Certificate granted. 

Choctaw County Board — ^No examinations reported. 

Clarke County Board — No examinations reported. 

Clay County Board— James Clin Griffin, M. D., Medical College 
of Alabama, 1900. Certificate granted. 

Orlando E. Black, M. D., University of the South, 1901. Cer- 
tificate granted. 

Cleburne County Board— William Henry Greer, M. D., Grant 
University, 1900. Certificate granted. 

Thomas Tyler Wheeler, M. D., Chattanooga Medical College. 
1900. Certificate granted^ 



REPORT OF TBS BOARD OF CBN80R8. H^f 

Lee Roy Wright, M. D., UnlTersity of NaahYille, 1900. Cer- 
tiflcate granted. 

Coffee County Board — ^No examinations reported. 

Colbert County Board — ^No examinations reported. 

Conecuh County Board — ^No examinations reported. 

Coosa County Board — ^John Calvin McLeod» M. D., Birmingham 
Medical College. Certificate granted. 

Joseph Marshall Smith, M. D., Medical College of Alabama. 
Certificate granted. 

Covington County Board — ^William Whatley Pearson, M. D., 
Medical College of Alabama. 

Crenshaw County Board — ^Roddie Richardson, M. D., Medical 
College of Alabama, 1897. Certificate granjted. (Papers not sent 
np until July, 1900.) 

Thomas Carey Eiland, M. D., Montezuma University, Medical 
Department (Examination held in 1897. Papers not sent up until 
July, 1900). 

Cullman County Board — Luther Hays, M. D., Grant University, 
1900. Certificate granted. 

Dale County Board — ^No examinations reported. 

Dallae County Board — Emmet Lee Fuller, M. D., Medical Col- 
lege of Alabama, 1900. Certificate granted. 

Carlyle Kyser Yates, M. D., Baltimore Medical College, 1900. 
Certificate granted. 

William Bradley Palmer, M. D., Tulane, 1898. Certificate 
granted. 

DeKalh County Board — ^Joseph H. Bogle, M. D., Vanderbilt, 1900. 
Certificate granted. 

Sidney Johnston Vann, M. D., Medical Department University 
of Georgia, 1900. Certificate granted. 

Elmore County Board — ^Jesse Gulledge, M. D., Medical College 
of Alabama, 1900. (Certificate granted. 

Byron T. Dozier, M. D., Barnes Medical College, 1897. Certifi- 
cate granted. 

James Marvin Wallace, M. D., Vanderbilt, 1899. (Certificate 
granted. 

Joseph W. Maddox, M. D., University of Tennessee, 1900. Cer- 
tificate granted. 

Joseph Owen Dennison, M. D., Vanderbilt, 1893. Certificate 
refused. 

EsoamMa County Boord— No examinations reported. 



1X8 ^^^ MEDICAL ASSOCIATION OF ALABAMA. 

Etoioah County Board — ^William Henry Coleman, (colored), 
Meharry, 1900. Certificate refused. 

Fayette County Board — ^William Wallace Duncan, M. D., Birm- 
ingham Medical College, 1900. Certificate granted. 

James Lucian Batson, M. D., Vanderbilt, 1900. Certificate 
granted. 

Tarley William Jones, M. D., Vanderbilt, 1900. Certificate 
granted. 

Franklin County Board — ^Walter A. Gresham, M. D., Vander- 
bilt, 1900. Certificate granted. 

John David Liee, M. D., Memphis Hospital Medical College, 
1900. Certificate granted. 

Geneva County Board — Charley Bob Powell, M. D., Medical Col- 
lege of Alabama, 1900. Certificate granted. 

Oscar Lee Rivenbark, M. D., Ceorgia Eclectic Medical College, 
1893. Certificate granted. 

Charles Braxton McKinnon, M. D., Tulane, 1892. Certificate 
granted. 

Qreene County Board — ^No examinations reported. 

Hale County Board — William S. Anderson, M. D., Tulane,, 1900. 
Certificate granted. 

William Henry Coleman, M. D., (colored), Meharry, 1900. 
Certificate refused. 

Mark Christleab Otts, M. D., Medical College of Alabama, 
Certificate granted. 

Quarles Jemison Brown, M. D., Medical College of Alabama, 
1900. Certificate granted. 

Dodson Wright Tidmore, M. D., University of the South, 1899. 
Certificate granted. 

John Webb McGtehee, M. D., Tulane, 1900. Certificate granted. 

Henry County Board — ^James Robert Vann, M. D., Medical Col- 
lege Alabama, 1899. Certificate granted. 

Thomas Joseph Kennedy, M. D., University of the South, 1899. 
Certificate granted. 

Jackson County Board — ^William Bogart, Jr., M. D., Vanderbilt, 
1900. Certificate granted. 

Hugh C. McRee, University of Nashville, 1898. Certificate re- 
fused. 

Eugene R. Smith, Jr., M. D., Chattanooga Medical College, 1900. 
Certificate granted. 

William Richard McRee, Vanderbilt, 1887. Certificate refused. 



ABPORT OF THMI BOARD OF CEN80RB. X19 

William Earl Noel, M. D., Chattanooga Medical College, 1900. 
Certiflcate granted. 

Jefferson County Board — Heary Graham Sellers, M. D., Vander- 
bilt, 1900. Certiflcate refused. 

Carl Alexander Fox, M. D., Tulane, 1900. Certiflcate granted. 

Frank Allemong Lupton, M. D., Johns Hopkins, 1899. Certifl- 
cate granted. 

Zachariah Britton Chamblee, M. D., Birmingham Medical Col- 
lege, 1900. Certiflcate granted. 

Joseph Jefferson McEvoy, M. D., Atlanta Medical College, 1890. 
Certiflcate refused. 

John Locke Worceeter, M. D., Birmingham Medical College, 
1900. Certiflcate granted. 

Joseph Bobbins Wetherbee, M. D., JefFeraon Medical College, 
1900. Certiflcate granted. 

John Green Pittman, M. D., Columbia Medical College, 1900. 
Certiflcate granted. 

Charles Preston Eichelberger, M. D., University of Virginia^ 
1896. Certiflcate refused. 

George Phillip Heard, M. D., College Physicians and Surgeons^ 
N. T., 1894. Certiflcate granted. 

Nicholas Flood Hix, M. D., University of Virginia, 1900. Cer- 
tiflcate granted. 

Modie Ezra Cunningham, M. D., Birmingham Medical College, 
1900. Certiflcate granted. 

Urban Joseph Whitehead Peters, M. D., University of Pennsyl- 
vania, 1898. Certiflcate granted. 

Gaston Torrance, M. D., University of Virginia, 1897. Cer- 
tiflcate granted. 

Ruftts Crockett McGahey, Vanderbilt, 1878. Certiflcate refused. 

Andrew Sitlington Warwick, M. D., University City of N. T. 
Certiflcate granted. 

Hamilton Ralls Coston, M. D., Vanderbilt, 1889. Certiflcate 
granted. 

Lamar County Board — George Marvin Mllner, M. D., Birming- 
ham Medical College, 1900. Certiflcate granted. 

Arlando Berry Collins, M. D., Vanderbilt, 1900. Certiflcate 
granted. 

Lauderdale County Board — ^No examinations reported. 

Lau^rence County Board — ^Thomas Howard Irwin, M. D., Van- 
derbilt, 1900. Certiflcate granted. 

Lee County Board — ^No examinations reported 



l^Q THE MEDtOAL ABBOOIATIOlf Ot ALABAMA. 

Limestone County Board — ^No examinatlcna reported. 

Lowndes County Board — ^Mack Milton Strickland, M. D., Medi- 
cal College of Alabama, 1900. Certificate granted. 

Robert Lenoir Russell, M. D., Georgia College Medicine and 
Surgery, 1900. Certificate granted. 

Alex. Hood, M. D., Vanderbllt, 1900. Certificate granted. 

Charles Murray Rudolph, M. D., Medical College Alabama, 1900 
Certificate granted. 

Macon County Board — Phillip Malcolm Llghtfoot, M. D., Medl 
cal College Alabama, 1900. Certificate granted. 

Frank Means Johnston, M. D., University of SoutH, 1900. Cer 
tlficate granted. 

Madiaon County Board — ^T. H. Brandon, M. D., Denver Medl 
cal College, 1898. Certificate granted. (Examination held In 1899 
Papers not sent up until October, 1900). 

James Fulton Burman, M. D., University of Nashville, 1899 
Certificate granted. (Examination held in 1899. Papers not sent 
up until October, 1900). 

Justlna Lorena Ford, M. D., Herring Medical (College (Chicago), 
1899. (Certificate granted. 

Roy M. Buchanan, M. D., University Tennessee, 1900. Certifi- 
cate granted. 

Marengo County Board — ^No examinations reported. 

Marion County Board — ^James Luther Patton, M. D., Memphis 
- Hospital Medical College, 1900. Certificate granted. 

Marshall County Board — ^Montgomery Gilbert Shipp, M. D., 
Vanderbilt, 1900. Certificate granted. 

John Calhoun Harris, M. D., Chattanooga Medical College, 1900. 
Certificate granted. 

Daniel Parrls, M. D., Chattanooga Medical College, 1900. Cer^ 
tlficate granted. 

D. Bruce Collins, M. D., Vanderbilt, 1900. Certificate granted. 

Delimus Wesley Wilson, Chattanooga Medical Ck>llege, 1900. 
Certificate granted. 

William Pelham Turk, M. D., Atlanta Medical College, 1892. 
Certificate granted. 

William Addison Elrod, M. D., University of South, 1900. 
Certificate granted. 

James Tolliver Elrod, M. D., University of South, 1900. 
Certificate granted. 

Mobile County Board — ^Marion Joseph Bancroft, M. D., Medi- 
cal College of Alabama, 1899. Certificate granted. 



RgPORT OF THE BOABD Of CENaORB. l2l 

Bmmitt Hilbert Bottom, H. D., St LouU Medical OoUagtt, 1897. 
Certificate refused. 

WilUam Claiborne WiUiaiiui» M. D., Medical CoUese of Alar 
bama, 1900. Certificate granted. 

William Williard 8. Maaon, M. D.. New Orleans Universltj, 1900. 
Certificate refused. 

Monroe County Boani— Russell Aubrey Smith, M. D., Medical 
College Alabama. Certificate granted. 

Edward Lamar Kelly, M. D., Medical CoUege Alabama, 1900. 
Certificate granted. 

Montgomery County Board — Coleman Ferrell Pearson, M. D., 
Medical College of Alabama, 1900. Certificate granted. 

Morgan County Board — ^Walter Scott Rountree, M. D., Birm- 
ingham Medical College, 1900. Certificate granted. 

Henry Roger Williams, M. D., (colored), Meharry, 1900. Cer- 
tificate granted. 

Perry County Board — ^Alfred Dennis Simington, M. D., (colored), 
Meharry. Certificate granted. 

Pickene County Board — ^No examinations reported. 

Pike County Boord— Benjamin C. Stewart, M. D., Medical Col- 
lege of Alabama, 1900. Certificate granted. 

John David Johnston, M. D., Atlanta Ck>llege Physicians and 
Surgeons, 1900. Ortificate refused. 

Francis Asbury Boewell, M. D., Medical College of Alabama, 
1900. Certificate granted. 

Randolph County Board — ^Andrew Jackson Clardy, M. D., Chat^ 
tanooga Medical Ck>llege, 1900. Certificate refused. 

RuseeU County Board — ^No examinations reported. 
8t, Clair County Board — James Perry Turner, M. D., Birming- 
ham Medical College, 1900. Certificate granted. 

Shell>y County Board — Andrew Wailes Horton, M. D., Medical 
0>llege of Alabama, 1899. Certificate granted. 

Charles Thomas Acker, M. D., Birmingham Medical College, 
1900. (Certificate granted. 

Robert Samuel Glasgow, M. D., Uniyerslty of South, 1900. 
Certificate granted. 

Sumter County Board — Dudley Stennis, M. D., University of 
NashTiUe, 1900. Certificate granted. 

Robert BUyson Harwood, M. D., Medical College of Alabama, 
Certificate granted. 

William Henry Stephens, M. D., Meharry, 1900. Certificate 
granted. 



1<J2 TB^ MEDICAL AdSOCtATlOlf OF ALABAMA. 

Duke Price Jones, M. D., Medical College Alabama, 1900. Cer- 
tificate refused. 

Talladega County Board — 'So examinations reported. 

Tallapoosa County Board — No examinations reported. 

Tuscaloosa County Board — ^Alston Fitts, M. D., Columbia Uni- 
versity, N. Y., 1895. Certificate granted. 

John Hester Ward, M. D., Uniyersity of the South, 1899. 
Certificate granted. 

Walker County Board — No examinations reported. 

Washington County Board — ^Rowell Wilbur Shaw, M. D., Mem- 
phis Hospital Medical College, 1900. Certificate granted. 

Wilcox County Board — Phillip Van Buren Speir. M. D., Medi- 
cal College of Alabama, 1900. Certificate granted. 

Winston County Board — ^William E. Howell, M. D., Birming- 
ham Medical College, 1900. Certificate granted. 

A. Costa Watts, M. D., Louisville Medical College, 1892. Cer- 
tificate granted. 



PART ni. REPORT OF THE STATE COMMITTEE OF PUBLIC 

HEALTH. 

For the past year, in addition to the usual diseases, 
smallpox and scarlet fever have prevailed to a consid- 
erable extent. The former disease continues to pre- 
vail much as it has done for the past four years, and 
so far as we are able to see will so continue until the 
State gives us the legislation necessary to exterminate 
it. This the State has not done, therefore, the respon- 
sibility rests upon the law-makers and not upon the 
doctors. As health officials we can only advise, and if 
our advice is not heeded by the State, county, and mu- 
nicipal authorities the onus does not rest upon our 
shoulders. 

In all counties where the Commissioners supply the 
necessary funds and give the medical authorities proper 
supjyort outbreaks of smallpox are promptly contix)lled, 
but in counties where a diflferent policy is pursued the 
disease retains its foothold and spreads to other coun- 
ties. It is clear, that if extermination can be accom- 
plished in one county it can be in another — hence a 
simultaneous effort to exterminate the disease, made 



REPORT OF TBS BOARD OF 0BNB0R8. 



123 



by all of the counties in the State, would very 
soon prove successful. Such simultaneous effort 
can not be secured without additional l^islation, and 
this we have been unable to obtain. 

During the year scarlet fever has had wide prevalence, 
but fortunately has been mild in type. In many of the 
places where the disease appeared its origin could not be 
traced, and after its appearance in a locality frequently 
the spread of the disease from one patient to another 
could not be satisfactorily accounted for. 

Diphtheria has also occurred in a good many locali- 
ties, but has had no extensive prevalence. Recently, a 
circular letter of inquiry as to the number of cases of 
8mallx>ox, scarlet fever, and diphtheria then existing in 
the various counties of the State was sent out. 

The subjoined table gives the reports received from 
all the counties in the State except six : 



Report on the Bmallpox, Diphtheria, and Scarlet Fever Situation 

in the Various Counties — April, 1901. 



COUNTIES. 



Smallpox. 
I No. Cases. 



Diphtheria. I Scarlet Fever 
No. Cases. | No. Cases. 



Autauga 





26 





25 

1 
2 



7 




















16 













Baldwin 





Barbour 





Bibb 





Blount 





Bullock 





Butler 





Calhoun 





Chambers 





Cherokee 





Chilton 





Choctaw 





Clarke 





Clay 





Cleburne 





Coffee 


V 




Colbert 





Conecuh 





Cooea 





Covington 





Crenshaw 







w 



124 



THE MSDIOAL ABB0ClATl02f OF ALABAMA, 



Report on the SmaUpox, DipMheria, cmd Scarlet Fever Situation in the 

Vcurious Coimties. — Contrived, 



COUNTIES. 


Smallpox. 
No. Cases. 


Diphtheria. 
No. Cases. 


Scarlet Fever 
No. Cases. 


Cullman 





10 





1 




3 

36 


2 

10 
1 



85 
6 




1 

60 




6 

10 
4 
6 

















6 













1 















Dale 





Dallas 


2 


DeKalb 





Blmore 





Bscambia 


4 


Btowah 





Fayette 





Franklin 





Geneva 





Greene 

Hale 






Henry 


8 


Jackson 





Jefferson 


16 


Lamar 





Lawrence 





Lauderdale 





Lee 





Limestone 





Lowndes 





Maoon 

Madison 






MarenRo 





Marion 





Marshall 





Mobile 





Monroe 





Montgomery 


2 


Morgan 





Perry 





Pickens 





Pike 





Randolnh 





Russell 





St Clair 





Shelby 


1 


Sumter 





Talladega • 







w 



REPORT OF THE BOARD OF 0BN80R8. 



126 



Report on the SmaUpox, Diphtheria, and Socuiet Fever SUuatilion in the 

Various Covnties. — Continued, 



COUNTIES. 

Tallapoosa 

TuBcalooea 

Walker 

Washington 

Wilcox 

Winston , 



Smallpox, 
No. Cases. 

s — 

5 
15 






Diphtheria. 
No. Cases. 



Scarlet Fever 
No. Cases. 



Total 



307 




2 






24 



6 
2 







85 



THE COLLECTION OP VITAL AND MORTUARY STATISTICS. 

The work of collecting vital and mortuary sffcatiotics 
for the year just closed has been attended by much the 
same results as for several years x>ast. 

In some counties Idie work is very satisfactorily done 
and in other counties nothing is accomplished. Betwixt 
these two extremes everv gradation of success is found. 

The following classification is submitted, giving, as 
it does, a very fair summary of results : 

1. Counties that have done excellent work. 

Baldwin, Bullock, Clay, Conecuh, DeKalb, Escambia, Etowah, 
Fayette, Jackson, Jefferson, Lawrence, Mobile, St Clair, Shelby, 
Winston— 15. 

2. Counties that have done fairly good work: . 

Barbour, Butler, Calhoun, Coosa, Crenshaw, Dallas, Hale, El- 
more, Qeneva, Madison, Morgan, Pike, Randolph, Sumter, Talladega, 
Tallapoosa, Tuscaloosa. — 17. 

3. Counties in which the work ha« been imi)erfectly 
done: - 

Bibb, Blount, Cherokee, Choctaw, Clarke, Cleburne, Coffee, Cull- 
man, Henry, Lamar, Monroe, Marshall — 12. 

4. Counties in Which the work has been practically 
neglected. 



126 



THE MEDICAL A8B00IAT10N OF ALABAMA. 



Autauga, Chambers, Chilton, Colbert, Covington, Dale, Franklin, 
Greene, Lauderdale, Lee, Limestone, Lowndes, Macon, Marengo, 
Marion, Perry, Pickens, Russell, Walker, Washington, Wilcox — 21. 

The difference in results is very easily accounted for. 
In counties that appropriate adequate, or something 
like adequate, salaries for their health officers the work 
is satisfactorily carried on; in counties that appi-opri- 
ate very inadequate salaries, the work is very imper- 
fectly done ; in counties that appropriate no salaries at 
all, the work is wholly neglected. 

But one remedy can be applied, and that is for the 
legislature of the State to enact a law making it man- 
datory on the commissioners of the several counties to 
appropriate adequate salaries for their health officers. 



FINANCIAL STATEMENT. 



The State Boabd of Health, 

In Account with The State of Alabama: 

OKBITS. 

1900. 

April 30, To cash from Treasurer |250 00 

May 31, cash from Treasurer 250 00 

June 30, cash from Treasurer 250 00 

July 31, ctish from Treasurer 250 00 

Aug. 31, cash from Treasurer 250 00 

Sept 30, cash from Treasurer 250 00 

Oct. 31, cash from Treasurer 250 00 

Nov. 30, cash from Treasurer 250 00 

Dec. 81, cash from Treasurer 250 00 

1901. 

Jan. 31, cash from Treasurer 250 00 

Feb. 28, cash from Treasurer 250 00 

March 31, cash from Treasurer 322 55 

March 31, cash returned for postage loaned Examina- 
tion Papers account 33 54 

March 31. cash returned for postage loaned Book of Rules 

account 1 80 

Total receipts |8,107 89 



REPORT OF THE BOARD OF 0EN80RB. 127 

CBKDITS. 
1900. 

April 1, by cash due examination iMtpera acct. from last 

year I 111 70 

10, By cash for postage 10 00 

16, cash for expreseage on letter heads from 8t. 

Louis 1 10 

23, cash for postage 10 00 

27. cash for box rent 1 60 

30. cash Health Officer's salary (April) 150 00 

30, cash clerk's salary (April) 41 65 

Hay 9, cash postage 10 00 

14, cash expressage on pkg from New Orleans.. 50 

19, cash postage 10 00 

19, cash W. U. Telegraph Co. (Montgomery) 2 68 

31, cash Health Officer's salary (May) 150 00 

31, cash clerk's salary (May) 41 65 

June 5, cash National Dispensatory 8 00 

9, cash W. U. Telegraph Co. (Montgomery) 8 30 

9, cash Postel Telegraph Co. (Mobile) 2 36 

9, cash Dr. J. P. Fumiss (expenses incurred in 

attending called meeting Public Health 

Committee) 3 00 

9, cash Postal Telegraph Co. (Montgomery) 1 07 

12, cash J. H. Stewart and F. L. Pettus, attorneys, 

for legal services Supreme Court (Per- 
ry county case) 100 00 

19, cash postage 10 00 

30, cash Health Officer's salary (June) 150 00 

30, cash clerk's salary (June) 41 65 

July 7, cash Jas. E. Maddox, water cooler, etc 4 95 

9, cash telegram 25 

9, cash telegram 45 

10, cash postage 10 00 

10 cash box rent 1 50 

12 cash Postal Telegraph Co. (Montgomery) l 72 

12 cash Emma Mack for scouring floor in office. . 50 
14, cash to Chas. Wood for cleaning out office, 

moving books, etc, into cellar 1 so 

17, for 1,000 stamped (2c) envelopes 21 20 

28, postage 10 OO 

31, Health Officer's salary (July) 150 00 

31, clerk's salary (July) 41 $5 



j[28 ^^^ MEDICAL ASSOCIATION OF ALABAMA. 

Aug. 2, W. U. Telegraph Go. (Montgomery) 6 24 

9, drayage on books from Washington 25 

18, envelopes (Ic) 2 00 

20, postage 10 00 

20, Ed G. Fowler A Co. (stationery and office sup.) 6 20 

26, W. U. Telegraph Ck>. (Mobile) 1 60 

31, Health Officer's salary (August) 150 00 

31, clerk's salary (August) 41 65 

Sept. 26, postage 10 00 

26, G. T. Bogacki, screen for office window 8 00 

30, Health Officer's salary (September) 150 00 

30, clerk's salary (September) 41 65 

Oct. 11, drayage on books from Washington 25 

12. box rent 1 60 

23, postage and envelopes for circulars 11 50 

27, expressage on pkg. from HuntsvlUe 40 

31, Health Officer's salary (October) 150 00 

31, Glerk's salary (October) 41 65 

Nov. 1, expressage pkg. from St Louis (Letter Hds.) 1 10 

10, postage 10 00 

14, W. U. Telegraph Go. (Montgomery) 3 62 

30, Health Officer's salary (November) 150 00 

30, clerk's salary (November) 41 65 

Dec. 12, postage 10 00 

22, postage for annual blanks 15 00 

29, W. U. Telegraph Go. (Eutaw, Ala.) 2 29 

31, Health Officer's salary (December) 150 00 

31, clerk's salary (December) 41 65 

1901. 

Jan. 1, envelopes (Ic) for circulars 8 00 

4, Abe Griffin, carpenter work in office 1 45 

14, 1,000 stamped (2c) envelopes 21 20 

14, Southern Bell Tel. A Tel. Go 80 

25, postage 10 00 

28, W. U. Telegraph Go. (Montgomery) 3 08 

29, box rent 1 50 

31, Health Officer's salary (January) 150 00 

31, clerk's salary (January) 41 65 

Feb. 8, drayage on books from Washington 25 

20, Ed. G. Fowler A Go. (office supplies) 17 85 

26, postage 10 00 

28, Health Officer's salary (February) 150 00 

28, clerk's salary (February) 41 65 



RBPOBT OF THE BOARD OF 0ENB0R8. ^29 

March 5, Robt F. lAgon, Supreme Court costs in Perry 

county case 21 50 

20, postage 10 00 

30, Watts, Troy ft Cafley, attorneys (retainer fee) 50 00 

30, Geo. D. Barnard ft Co., 4,000 letter heads 29 50 

30, W. U. Telegraph Co. (Montgomery) 4 67 

30, E. L. Davant, cleaning and repairing typewriter 5 26 

30, postage 10 00 

30, Brown Printing Co. (blanks, etc.) 173 00 

30, Morgan D. Jones, postal guide, with supple- 
ments 2 00 

30, Ed. C. Fowler ft Co. (office supplies) 6 10 

30, C. W. lyey, register in chancery. Perry Co. . . . 64 98 

30, box rent 1 60 

30, Postal Telegraph (3o. (Mobile) 8 04 

30, Montgomery Advertiser 2 00 

30, Postal Telegraph Co. (Montgomery) 2 80 

30, HeaHh Officer's salary (March) 160 00 

30, clerk's salary (March) > 41 66 

80, Health Officer's expense acct for the year 164 34 

Total expenditures 13,846 19 

Recapitulation. 

By total expenditures April 1, 1900, to April 1, 1901 |3,846 19 

To total receipts April 1, 1900. to April 1, 1901 8,107 89 

By balance due examination papers account 287 30 

The undersigned appointed special Auditing Committee, hare 
examined this account and find the same correct 

W. M. WILKBRSON, M. D. 
GLENN ANDREWS, M. D. 



During the reading of the report of the Board of Cen- 
sors the separate sections thereof were submitted to the 
Association seriatim and acted upon in the order in 
which they were read. 

The Board reported adversely to the adoption of the 
first recommendation of the President (see p. 14), or 
that proposing to change the organic law of the Associa- 
tion 00 as to confer the privilege of voting ux>on all mem- 



130 ^^^ MEDICAL AB800IAT10N OF ALABAMA. 

bers of county societies in affiliation with the Associa- 
tion upon the payment of an annual fee of five dollars 
each. 

Motion was made and seconded to concur in that sec- 
tion of the report, whereupon President Cunningham 
called Vice-President Pride to the chair and arose to a 
question of personal privilege, arguing earnestly and at 
considerable length in behalf of his recommendation. 

Dr. Sanders, Chairman of the Board of Censors, also 
arose to a question of personal privilege and enthusiasti- 
cally defended the positions set forth in the report. 

The motion to concur in the section of the Rejyort read 
was adopted. 

The section of the Report referring to the President's 
second recommendation (see p. 15), or that proposing 
"that the Association offer a prize of twenty-five dollars 
for the best jmper upon any one subject pertaining to 
Medical Topography or Climatology in this State" was 
next read. The Board advised that the recommendation 
of the President be not adopted in the form made, but 
suggested that the spirit of the recommendation might 
be carried out in the future in another way. 

Upon motion this section of the Report of the Board 
of Censors was unanimously adopted. 

The Report recommended that the Association en- 
dorse the President's third recommendation (see p. 15), 
namely, that a stenographer be employed to take down 
the proceedings of the meetings of the Association and to 
furnish type-written copies thereof. 

Upon motion this section of the report was concurred 
in. 

The Report proceeded to state that believing its action 
^I'ould be approved by the Association it had employed 
a stenographer for this meeting. 

The Report endorsed the President's fourth recom- 
mendation (see p. 16 ) , namely, that "the county socie- 
ties have annual, semi-annual, or quarterly social enter- 
tainments as a part of their regular work," and ex- 
pressed the belief that if carried out the effect of this 
recommendation would prove beneficial. 

Dr. E. T. Camp, of Gadsden, offered the following reso- 
lution as an amendment to the section of the report 
under consideration: 



ACTION ON REPORT OF BOARD OF CENSORS. I3I 

Resolved, That it is the sense of this Association that county 
medical societies should, at frequent Intervals, Invite members of 
other societies to attend their meetings, for the purpose of present- 
ing papers upon medical subjects and engaging In such discussions 
as may arise, firmly believing that the adoption of this custom would 
be productive of much good, by promoting harmony of feeling, and 
Interchange of views upon medical questions. 

The Board accepted the amendment, whereupon, this 
section of the Report as amended was adopted. 

The Report took issue broadly with the President's 
fifth recommendation (tsee pp. 25-26), and advised that 
it be not adopted. 

This section of the Rejwrt was discussed at consider- 
able length by President Cunningham and Drs. Moody 
and Sanders. In the course of this ailment President 
Cunningham admitted that last year he did regard it bad 
policy to appeal to the legislature to change our law regu- 
lating the practice of medicine, and so advised, but he 
insisted that conditions have changed, rendering what 
was bad policy then good policy now, just as a surgeon 
might advise against the amputation of an injured limb, 
but seeing it at a later period, when gangrene had set in, 
he would certainly change his advice. 

Upon motion this section of the Report was unani- 
mously adopted. 

The next section of the Report warmly endorsed the 
President's sixth recommendation (see p. 33), namely 
that this Association adhere to its determination to erect 
a monument to the memory of the founder of, and long 
the distinguished leader in, our system of organization. 

Upon motion this section of the Report was unani- 
mously adopted. 

The next section of the Rei)ort referred to the Re- 
ports of the Vice-Presidents and after being read was 
unanimously adopted. 

The section referring to the Report of the Secretary 
was next read and unanimously adopted. 

The section referring to the report of the Committee 
at Publication was next read and unanimously adopted. 



132 ^^^ MEDIOAL A8B00IATI0N OF ALABAMA. 

The section referring to the report of the Treasurer 
was next read and unanimously adopted. 

The section referring to the accounts of the State 
Health Officer was next read and unanimously adopted. 

The section referring to the revision of the Minutes of 
1900 was next read and unanimously adopted. 

The section referring to delinquent County Societies 
was next read and unanimously adopted. 

The next section referring to a new edition of tlie 
Book of the Rules and to New Charters was next read 
and unanimously (adopted. 

The section referring to a visit to Washington by the 
State Health Officer was next read and unanimously 
adopted. 

The section referring to jails and poor houses was next 
read and unanimously adopted. 

The section referring to an "Ordinance Enacted Last 
Year" and containing a projwsed amendment to Article 
70, section 14, of the Constitution of this Association, 
was next read and unanimously adopted, the proposed 
amendment to the Constitution having been read and be- 
ing ordered to lie over until next year. 

The section referring to legislation was next read and 
unanimously adopted. 

At this point Dr. E. B. Ward, of Selma, asked per- 
mission to interrupt the reading of the report in order 
to submit a resolution, which being granted, he read the 
following resolution: 

Resolvedj That this Association warmly endorses the action of 
the State Health Officer, Dr. W. H. Sanders, and of those who co- 
operated with him, in opposing a bill entitled: "A Bill to Extend 
and Better Establish, Maintain and Regulate the Duties and Author- 
ity of the Quarantine Board of Mobile Bay," introduced into the 
recent session of the General Assembly by Hon. R. H. Clarke, of 
Mobile, and regards the defeat of the bill as an important achieve- 
ment, in that, it prevented a dangerous interference with the gen- 
eral quarantine laws of the State. 

Upon motion being made and seconded to adopt the 
resolution, Dr. Ward supported it by an earnest and en- 
thusiastio argument, after which it was unanimously 
adopted by a rising vote. 



ACTION 02i REPORT OF BOARD OF OSifaORa. I33 

The section of the report containing the drafts of four 
new ordinances was next read and adopted, each ordi- 
nance being voted upon separately. 

The next section of the report referring to a bond for 
the Treasurer was read and unanimously adopted. 

The next section of the report, referring to the em- 
ployment of an attorney for the Association, was read 
and unanimously adopted. 

The next section of the report referring to "Dry Tor- 
tiigas" was read and unanimously adopted. 

The next section of the report, referring to Inter-State 
Notification as to the presence of yellow fever, was read 
and unanimously adopted. 

The next section of the report, referring to "Working 
Convicts in Mines," was read and unanimously adopted. 

The next section of the report, referring to the ap- 
pointment of a "Committee of Sociological Science," was 
read and unanimously adopted. 

The next section of the report, referring to Banks of 
Deposit, was read and, upon motion to adopt, the Asso- 
ciation refused to concur in the recommendation of the 
Board to the effect that the First National Bank of 
Greensboro be made one of the banks of deposit of the 
funds of the Association. 

Motion was made to reconsider the vote just taken, 
and after some discussion and explanation, the Associa- 
tion adopted the motion. 

The original question was then submitted and 
adopted. 

The section of the report referring to the case of Dr. 
A. J. Coley, was then read and unanimously adopted. 

The section of the report, headed "Loyalty to the Asso- 
ciation," was next read and unanimously adopted. 

The second part of the report, embracing Examina- 
tions for License to Practice Medicine by the State 
Board, Examination Papers Account, The Book of the 
Rules Account, and Examinations by the County Boards, 
was submitted without being read and adopted. 

Part three of the report, embracing the report of the 
State Committee of Public Health, the Financial State- 
ment of the State Board of Health, and the Collection 
of Vital and Mortuary Statistics, was submitted without 
being read and adopted. 



134 ^^^ MEmCAL ABSOCtATIOIf OF ALABAMA. 

Upon motion the report as a whole was then unani- 
mously adopted. 

Dr. W. H. Sanders^ Chairman of the Committee on the 
Cochran Monument, submitted the following report : 

To the President and Members of the Medical Association of the 
State of Alahama: 
The plan proposed by the committee last year for providing the 
funds necessary for the erection of a monument to Dr. Jerome Coch- 
ran, deceased, was that fifteen hundred dollars be raised annually 
by the County Medical Societies, the amounts to be contributed by 
the several societies to be proportioned to their numerical strength 
and financial ability. 

It was estimated that five thousand dollars would be needed, 
therefore, three years or a little more would be required to secure 
the necessary sum. 

In pursuance of the authority granted the committee, the fol- 
lowing assignment of amounts to be raised by the several counties 
for the present year is submitted : 

Autauga county, $10.00; Baldwin, $7.00; Barbour, $35.00; Bibb, 
120.00; Blount, 116.00; Bullock, $38.00; Butler, $30.00; Calhoun, 
$45.00; Chambers, $15.00; Cherokee, $12.00; Chilton, $10.00; Choc- 
taw, $12.00; Clarke, $20.00; Clay, $15.00; Cleburne, $12.00; Coffee, 
$12.00; Colbert, $12.00; Conecuh, $20.00; Coosa, $12.00; Covington, 
$6.00; Crenshaw, $20.00; Cullman, $15.00; Dale, $20.00; Dallas, 
$60.00; DeKalb, $15.00; Elmore, $20.00; Escambia, $12.00; Etowah, 
$20.00; Fayette, $12.00; Franklin, $15.00; Geneva, $16.00; Greene, 
$16.00; Hale, $20.00; Henry, $25.00; Jackson, $18.00; JefTerson, 
$200.00; Lamar, $8.00; Lauderdale, $15.00; Lawrence, $14.00; Lee, 
$12.00; Limestone, $16.00; Lowndes, $20.00 ;. Macon, $12.00; Madi- 
son, $50.00; Marengo, $30.00; Marion, $7.00; Marshall, $10.00; Mo- 
bile, $70.00; Monroe, $15.00; Montgomery, $100.00; Morgan, $12.00; 
Perry, $10.00; Pickens, $20.00; Pike, $18.00; Randolph, $20.00; Rus- 
sell, $12.00; Shelby, $16.00; St. Clair, $15.00; Sumter, $20.00; Talla- 
dega, $45.00; Tallapoosa, $25.00; Tuscaloosa, $25.00; Walker. $20.00; 
Washington, $8.00; Wilcox, $30.00; Winston, $5.00. Total, $1,542.00. 

The Committee proposes to solicit the active co-operation of one 
or more members of each County Society in an effort to raise the 
above amounts. 

A special receipt book will be kept, in which will be recorded, not 
only the total amount contributed by each society, but the separate 
amounts contributed by each member thereof, when this can be ob- 
tained. 



REVISION OF BOOK OF THS ROLLS. 135 

All monies received will be depoeited in bank to the credit of the 
"Cochran Monument Fund/' and will be held inviolate for that pur- 
pose, and subject to the order of the Association. 
(Signed.) 

W. H. Sandkbs, M. D. 
J. B. Gaston, M. D. 
B. J. Baldwin, M. D. 

Committee. 

The report was unanimously adopted and the commit- 
tee authorized to proceed with the work in accordance 
with the recommendations contained therein. 

The President then announced the revision of the four 
following named rolls as the next business in order : 

1. The Roll of County Societies. 

2. The Roll of the College of Counsellors. 

3. The Roll of the Correspondents. 

4. The Roll of the Officers. 

The revision of the first roll or that of County Medical 
Societies was then proceeded with. 

1. THE REVISION OP THE BOLL OP COUNTY SOCIETIES. 

The standing committee on the revision of the rolls, 
composed of the Secretary, the Senior Censor, and the 
Treasurer, reported three schedules of county societies 
as follows : 

(a). Societies that have fulfilled all of their Constitu- 
tional obligations, that is, are represented at 
this meeting by delegates, have submitted 
reports, and paid dues: 

Barbour, BuUock, Cherokee, Choctaw, Clarke, Cleburne, Conecuh, 
Cullman, Dale, Dallas, DeKalb, Elmore, Escambia, Etowah, Fayette, 
Hale, Jackson, Jefferson, Lamar, Macon, Madison, Marengo, Marion, 
Marshall, Mobile, Montgomery, Perry, Randolph, Russell, Shelby, 
Sumter, Talladega, Tallapoosa, Tuscaloosa, Walker, Washington. 
Total, 36. 

No objection being made to the correctness of this 
schedule, the President ordered that these thirty-six so- 
cieties W passed las clear of the books : 



136 ^^S MEDWAL ABSOOIATIOH OV ALABAMA^ 

(ft.) Societies Partially Delinquent. 

Autauga, delinquent In dues; Baldwin, delinquent in dues and 
report; Bibb, delinquent in dues; Blount, delinquent in dues; Butler, 
delinquent in delegates; Calhoun, delinquent in dues; Chilton, de- 
linquent in delegates and report; Clay, delinquent in delegates and 
report; Coffee, delinquent in report; Coosa, delinquent in delegates; 
Franklin, delinquent in report; Geneva, delinquent in dues; Greene, 
delinquent in delegates; Henry, delinquent in dues; Lauderdale, de- 
linquent in report; Limestone, delinquent in delegates and dues; 
Lowndes, delinquent in delegates and dues; Lawrenec, delinquent 
in delegates; Monroe, delinquent in dues and report; Pickens, delin- 
quent in delegates and dues; Pike, delinquent in dues; St. Clair, de- 
linquent in delegates; Wilcox, delinquent in delegates; Winston, 
delinquent in delegates. Total, 24. 

No objection being made to the correctness of this 
schedule, the President ordered that these t^^enty-three 
county societies be passed, with the understanding that 
the Secretary and the Treasurer would endeavor to ob- 
tain the missing reports and dues. 

(c.) Societies Totally Delinquent. 

Chambers, Colbert, Covington, Crenshaw, Lee and Morgan. To- 
tal, 6. 

No objection being made as to the correctness of this 
schedule, the President ordered that these six county 
societies be referred to the Board of Censors for inves- 
tigation. 

The revision of the roll of county societies was here 
ended, and the President ordered that said roll shall 
stand closed until the next annual meeting of the Asso- 
ciation. 

(2) . THE ROLL OF THE COLLEGE OF COUNSELLORS. 

The committee on the revision of the rolls reported the 
seven schedules of the Counsellors, as follows : 



RBVI8I0N OF BOOK OF THE ROLLB. \%^ 

(d.) Counsellors Clear of the Books. 

Qrand Seniors.— Baldwin, B. J.; Bragg, S.; Brockway, D. S.; 
DeWeese, T. P.; Fletcher, R. M.; Franklin, C. H.; Ooggans, J. A.; 
Goode, R.; Goodwin, J. A.; Harlan, J. J.; Hill, L. L. ; Huggins. 
J.; Inge, H. T.; Jay, A.; Jones, C. C; Kendrick, J. C; LeOrande, 
J. C. ; Lowry, 8. H.; Mar6chal, B. L.; Nolen, A. J.; Redden, R. J. ; 
Robertson, T. L.; Searcy, J. T. ; Sledge, W. H. ; Stovall, A. M.; Thet- 
ford, W. F.; Trent, P. G.; Whaley. L.; Wheeler. W. C; Wilkorson, 
W. M.; Wilkerson, C. A. Total, 31. 

Seniors— Andrews. G;. Bell. W. H.; Blake, W. H.; Bondurant, B. 
D.; Brown, G. S.; Cameron, M. B.; Coley, A. J.; Cunningham, R. 
M. ; Davis, W. B. B.; Desprez, L. W.; Duggar, R. H.; Frazer, T. H.; 
Gay, 8. G.; Harper, R. F.; Heflin, W.; Hill, G. A.; Hunter. H. M.; 
Howie. J. A. ; Johnston, L. W.; King, G.; McCants, R. M.; McLaugh- 
lin. J. M.; Moody, H. A.; Moon, W. H.; Parke, T. D.; Perry, H. 
G.; Rlggs. B. P.; Sutton, R. L.; Swann, J. C; Williams, J. H.; 
Watkins, I. L.; Whitfield, B. W.; Wilkerson, J. B. Total, 33. 

Juniors. — ^Bancroft, J.; Brannon. H. L.; Bennett, B. F.; Dixon, 
J.; Dryer, T. B.; Gaston, J. L.; Guice, C. L.; Harlan, A. L.; Har- 
rison, W. G.; Henderson, S. C; Henley, A. T.; Hill, R. S.; Jones, 
J.; Jones, B. S.; Justice, O. S.; McCain, W. J.; McBachem, J. A.; 
Pearson, B. R.; Pride, W. T.; Robinson, T. F.; Sims, A. G.; Wal- 
ler, G. P.; Welch, S. W.; Whitfield, J. B.; Wyman, B. L. Total, 26. 

No objection being made to the correctnesB of this 
Bchednle, the President ordered that the Gonnsellors^ 
(eighty-nine in number )y w^hose names had been read, 
be passed as clear ot the books. 

(e.) Delinquent Counsellors. 

Watson, W. W. (Counsellor-elect, 1900) Furman. 

No objection being made to the correctness of this 
schedule, the President, under the rules, ordered that the 
counsellor, whose name had been read as delinquent, 
should be stricken from the roll of the Collie of Coun- 
sellors, and that of this action he shall be duly notified 
by the Secretary. 

(f.) Miscellaneous Counsellors. 

Counsellor who resigned. — Quinn, W. E. (Senior 1894), Ft Payne. 



138 ^^^ MEDICAL A8B00IAT10N OP ALABAMA. 

No objection being made as to the correctness of this 
schedule, the President, under the rules, ordered that the 
resignation of the Counsellor be accepted, and that his 
name be stricken from the roll of the Collie of Counsel- 
lors. 

CounseUor who died. — Moody, F. I. (Junior, 1896), Dothan. 

No objection being made to the correctness of this 
schedule, the President, under the rules, said : We are 
grieved to hear of the death of our brother counsellor ; 
let us cherish his memory in our hearts; and let his name 
and record be transferred to the Grand Roll of Honor. 
Itequiescat in pace. 

(g-) Or and Senior Counsellors of Ten Years Standing. 

Fletcher, R. M.; Jones, C. C; Robertson, T. L.; Thetford, W. 
F. Total, 4. 

No objection being made to the correctness of this 
schedule, the President, under the rules, ordered that the 
counsellors whose names had been read as having served 
ten consecutive years as Grand Senior Counsellors 
should be transferred to the Roll of Grand Senior Life 
Counsellors, and that of this transfer they shall be 
duly notified by the Secretary. 

(h.) Senior Counsellors of Five Years Standing. 
(None.) 

(;.) Junior Counsellors of Five Years Standing. 

Harrison, W. G.; Jones, Julius; Robinson, T. F.; Waller, G. P.; 
Whitfield, J. B. Total, 5, 

No objection being made to the correctness of this 
schedule, the President, under the rules, ordered that the 
counsellors, five in number, whose names had been read 
as having served for five consecutive years as Junior 
Counsellors, be transferred to the Roll of Senior Coun- 
sellors, and that of this transfer they shall be duly 
notified by the Secretary. 



RBVI8I0N OF BOOK OF THE ROLLS. 139 

(1.) GOUNSSLLOBS-BIiEOT. 

Ard, B. B., Ozark; Green, H., Dothan; Justice, R. L., Qeneva; 
Lawrence, W. J. D., Turkeytown; Maples, W. C, Scottsboro; Robert- 
son, W. H., Clayton; Tarn, S. S., Mobile; Thigpen, C. A., Montgom- 
ery. Total, 8. 

No objection being made to the correctness of this 
schedule, the President, under the rules, ordered that 
the counsellors-elect, eight in number, whose names had 
been read as having signed the counsellors pledge and 
as haying paid their dues, be transferred to the roll of the 
Junior O>unsellors, and that of this transfer they should 
be duly notified by the Secretary. 

The revision of the roll of Counsellors was here ended, 
and the President ordered that said roll shall stand 
closed until the next meeting of the Association. 

THE BOLL OF GOBBESPONDENTS. 

Bozeman, Nathan, M. D., New York, 1889. 
Gamett, A. S., M. D., Hot Springs, Ark., 1875. 
Hoffman, John R., M. D., Athens, Ala., 1890. 
Mitchell, WUliam, A., M. D., Eufaula, Ala., 1891. 
Moses, Gratz, M. D., St Louis, Mo., 1874. 
Osborne, Thos. C, M. D., Claiborne, Texas, 1885. 
Peavy, Julius, F., M. D., Ashville, N. C, 1899. 
Rorez, Jas. Polk, M. D., Scottsboro, Ala., 1891. 
Fletcher, R. M., Jr., M. D., Ft Harrison, Mont, 1900. 

The revision of the Boll of Ck>rrespondentB was here 
ended, and the President ordered that said roll shall 
stand closed until the next annual meeting of the Asso- 
ciation. 

( 4. ) THE BOLL OF THE OFFICERS. 

The Committee on the Revision of the Bolls reported 
that the election of the following named officers would 
now be in order : 

A President for one year. 

A Junior Vice-President for two years, (for the South- 
ern division of the State) . 



140 ^^B MSDIOAL ASaOCIATION OF ALABAMA. 

Two members of the Board of Censors for five years 
each, to succecxl Dr. C. H. Franklin, of Union Springs, 
and Dr. W. M. Wilkerson, of Montgomery, whose terms 
expire with this meeting. 

An Ora/tor and an Alternate Orator. 

No objection being made to the correctness of this re- 
port, the President, under the rules, ordered that elec- 
tions for the positions named be now proceeded with. 

The result of the several ballots taken was the election 
of the following named officers : 

President — Dr. E. L. Mar6chal, of Mobile. 

Junior Vice-President — Dr. M. B. Cameron, of Sum- 
terville. 

Censors for five years — Dr. C. H. Franklin, of Union 
Springs, and Dr. W. M. Wilkerson, of Montgomery. 

Orator — Dr. E. B. Ward, of Selma. 

Alternate Orator — Dr. L. 0. Morris, of Birmingham. 

Dr. Marshal said that as the Association had honored 
him with the presidency, he would tender his resignation 
as a member of the Board of Censors, which he did. 
The Association accepted the resignation, and the Presi- 
dent then announced that an election would be in order 
to fill the unexpired term of Dr. Mar6chal on the Board. 

A ballot was taken, the result of which was the elec- 
tion of Dr. H. A. Moody, of Bailey Springs, to succeed 
Dr. Mar^chal on the Board of Censors. 

The revision of the Roll of Officers was here ended, 
and the President ordered that said roll shall stand 
closed until the next meeting of the Association. 

THE ELECTION OF COUNSELLORS. 

The Committee on the Bivision of the Rolls reported 
that there were seven vacancies in the College of Coun- 
sellors, whereupon, the President announced that an 
election to fill these vacancies would now be in order. 

Dr. Q. A. Hill, Chairman of the Committee on the 
Nomination of Counsellors, reported that his committee 
had considered the subject very carefully, and had en- 
deavored to base the nominations upon both merit and 
geographical distribution. 

He then read the following list of nominees : 



aSTALLATtON OF OFFICERS. 141 

Br. J. R. O. Howeli of DoUiaii. Houy County; Dr. P. T. Flemins. 
of BnterpriBe, Coffee county; Dr. H. Li. Aiiplelon of Center, Cherokee 
county; Dr. T. A. Caaey, of AlbertriUe, lUrahnll county; Dr. B. B. 
Sims, of Talladega; Dr. W. G. Somerrille. of Tnscalooea; Dr. T. War- 
burton Jones, of Camden. 

Motion was made and adopted that the rule as to elec- 
tions be suspended, and that the Secretary of the Asso- 
ciation be authorized to cast the ballot of the Associa- 
tion for Counsellors. 

This was done and the President announced as the re- 
sult of the ballot that the nominees above mentioned had 
been elected to fill the seven vacancies in the Coll^^ of 
Counsellors. 

The President announced the installation of officers as 
the next order of business, but before proceeding with 
it, gave notice that under the authority granted him by 
the Association, he would appoint Dr. W. O. Somer- 
ville, of Tuskaloosa, and Dr. T. D. Parke, of Birming- 
ham, as members of the Sociological Committee provided 
for, — the Association having made him the third member. 

The President then appointed an installation commit- 
tee to escort the newly-elected officers to the rostrum to 
be introduced to the Association. 

Dr. E. L. Marshal, the newly-elected President, was 
first escorted to the rostrum, and after being warmly re- 
ceived by the retiring President, the latter vacated the 
chair. 

Dr. Marshal, upon assuming the x)osition of Presi- 
dent, made the following remarks : 

Gentlemen of the Medical Association of the State of Alabama: 
In accepting the official position to which I have been elected 

b7 your generous suffrages, I desire to express to you my grateful 
appreciation of the honor which you have conferred upon me — an 
honor of which any member of the profession might well be proud. 
This Association, charged as it is with the supervision of the public 
health and the enforcement of the law to regulate the practice of 
medicine in Alabama, has a great and important mission to fulfill. 
While carefully and intelligently endeavoring to minimize the num- 
erous dangers to which man's physical health is exposed, it seeks 
to dignify a noble profession by guarding the entrance to it so that 
those who are incompetent may not be permitted to utilize its in- 
signia for unworthy purposes. Certainly such commendable objects 



142 ^^^ MEDICAL ASSOCJATIOJi OF ALABAMA. 



k 



should enlist tbe actlTe oo-opermUoa and endonemoit of all public 
■piiited cfUxens. 

Mj appreciation of the honor which 70a haye conferred upon 
me is greatly intensified when I recall the fact that thirty years ago 
I was an humble student of medicine in the offlce of Jerome Cochran, 
whose masterful mind oonceiTed, and whose great genius created 
our present perfect organisation. Standing today and looking back- 
ward over the past history of this organiation we haTe ample cause 
for congratulation. In the few years that hare elapsed since our 
present system was inaugurated* the profession in the State has been 
regenerated — ^ignorance and incompetency hare been displaced by 
professional competency* while our health system has been recon- 
structed upon definite and improred lines. If the success of the past 
may be taken as an earnest of the future we may well give expres- 
sion to the motto of the Association — 

IfoM etiam speravimuM w^eJiora, 

Again thanking you, gentlemen, and with a sincere desire in 
all things to consenre the best interests of this Association, and 
logically of the people of the State, I bespeak, in the performance 
of my duties as your ezecutlTe oflloer, your generous support and 
active co-operation. 

President Marshal then annonnced as the next order 
of business the installation of the Junior Vice-President. 

Dr. M. B. Cameron was escorted to the rostrum and 
after being cordially received by the President, was in- 
troduced to the Association. 

Dr. Cameron, in a few graceful remarks, thanked the 
Association for the honor conferred, and promised his 
utmost fidelity in the discharge of his official duties. 

The installation of the newly-elected m^nbers of the 
Board of Censors was declared to be next in order. 

Upon investigation it was ascertained that Dr. G. H. 
Franklin had left, therefore, he being absent, the Presi- 
dent declared that he would succeed himself for another 
term of five years ux)on the Board of Censors. 

It was also found that Dr. W. M. Wilkerson was not 
in the hall, to be personally installed, the President 
therefore, announced that he would succeed himself on 
the Board of Censors for a term of five years. 

Dr. H. A. Moody, elected to succeed Dr. Marshal, 
was escorted to the rostrum and warmly wel- 
comed by the President as a member of the 



INSTALLATION OF 0PFI0BR8. 143 

Board of CenBors, wherenpoDy Dr. Moody accepted the 
honor and responsibility of the position in a few earnest 
and apprapritate remarks. 

The newly-elected orator, Dr. E. B. Ward and the 
newly-elected alternate orator. Dr. L. C. Morris, were 
next escorted to the rostrum and introduced by the 
President to the Association, both of whom, in brief but 
fitting words, thanked the Association for the honor con- 
ferred. 

The President then declared the selection of the next 
place of meeting in order. 

Dr. E. A. Jones, of Birmingham, extended a cordial 
inyitation tc the Ajssociation to hold its next meeting in 
that city. 

Dr. W. G. Harrison, of Talladega, said that not until 
recently had the hotel facilities of his town been ade- 
quate for accommodating the members of the Associa- 
tion, but he thought they were now, and said that he 
was authorized by his county medical society to extend 
to the Association a cordial invitation to hold its next 
meeting in Talladega. 

Upon a rising vote the invitation to hold the next meet- 
ing in Birmingham was accepted. 

Dr. Cameron, of Sumterville, moved that the cordial 
thanks of the Association be returned to the Dallas 
County Medical Society, to the Young Men's Christian 
Association, and to the press and people of Selma for 
courtesies and attentions rendered and also to the vari- 
ous railroads of the State for transportation to the meet- 
ing at reduced rates. 

The motion was, by a rising vote, unanimously 
adopted. 

The meeting was then adjourned sine die. 



144 THE MEDICAL ABBOCIATION OF ALABAMA. 



REGISTRATION LIST. 

During the meeting the following named counsellors, 
delegates, and members appeared and registered : 

« 

GRAND SENIOR LIFB COUNSELLORS. 

Jackaon, Robert Dandridge, Brookwood. 
McKlttrick, Adam Alexander, Eyergreen. 
Sanders, William Henry, Mobile. 
Starr, Lucius Ernest, Camden. 

GRAND SENIOR COUNSELLORS. 

Coley, Andrew Jackson, Alexander City. 
DeWeese, Thomas Peters, Gamble Mines. 
Franklin, Charles Hlggs, Union Springs. 
Goggans, James Adrian, Alexander City. 
Goodwin, Joseph Anderson, Jasper. 
Harlan, Joseph Jefferson, Hackneyville. 
Hill, Luther Leonldas, Montgomery. 
Huggins, Jacob, Newbeme. 
Jay, Andrew, Evergreen. 
Kendrick, Joel Cloud, GreenyiUe. 
LeGrand, John Clarke, Birmingham. 
Mar6chal, Edwin Leslie, Mobile. 
Nolen, Abner Jackson, New Site. 
Robertson, Thaddeus Llndley, Birmingham. 
Stovall, Andrew McAdams, Jasper. 
Thetford, William Fletcher, Talladega. 
Whaley, Lewis, Birmingham. 
Wllkerson, Charles A., Marion. 

SENIOR COUNSELLORS. 

Andrews, Glenn, Montgomery. 
Bell, Walter Howard, Hargrove. 
Brown, George Summers, Birmingham. 
Cameron, Matthew Bunyan, Sumtervllle. 
Cunningham, Russell McWhorter, Ensley. 
Davis, William Ellas Brownlee, Birmingham. 
Deeprez, Louis Wllloughby, Florence. 
Duggar, Reuben Henry, Gallion. 
Gay, Samuel Gilbert, Selma. 



DELEGATES. X45 



Hill, George Armstrong, Wynette. 
JohnBton, Loula William, Tuskegee. 
King, Goldsby, Selma. 
McCants, Robert Beall, Demopolis. 
Moody, Henry Altamont, Bailey Springa 
Moon, William Henry, Ooodwater. 
Parke, Thomas Duke, Birmingham. 
Perry, Henry Gaither, Greensboro. 
Sutton, Robert Lee, Omrille. 
Waller, George Piatt, Montgomery. 
Whitfield, Bryant Watkins, Demopolis. 

JUNIOR COUNSELLORS. 

Ard, Brastus Byron, Ozark. 
Dryer, Thomas Edmund, Huntsvllle. 
Guice, Charles Lee, Gadsden. 
Harrison, William Groce, Talladega. 
Hill, Robert Sommenrille, Montgomery. 
Justice, Robert Lee, Geneva. 
McCain, William Jasper, Liyingston. 
McESachem, John Adolphus, Brundldge. 
Pride, William Thomas, Madison. 
Robertson, William Henry, Clayton. 
Robinson, Thomas Franklin, Bessemer. 
Sims, Albert Gallatin, Renfroe. 
Tam, Silas Springer, Mobile. 
Welch, Samuel Wallace, Alpine. 
Whitfield, James Bryant, Demopolis. 



DELEGATES PRESENT. 

Autaugcb^hL. D. Smith, PrattTiUe. 
Baldvoin — ^J. H. Hastie, Stockton. 
Barhour — ^Judson Davie, Cowikee. 
Bi5&— M. C. Schoolar, Centerville. 
Blount — ^D. S. Moore, Clarence. 

Bullock — ^T. J. Dean, Union Springs; G. M. Guthrie, Inyemess. 

Btftler— None. 

Calhoun — ^B. C. Anderson, Anniston. 

Chambers — ^None. 

Cherokee — ^H. L. Appleton, Center. 

Chilton — ^None. 

10 



146 ^^^ MEDICAL ABSOOIATION OF ALABAMA. 

Choctaw — G. L. Oranberry, Pushmataha. 
Clarke — L. O. Hicks, Jackson. 
Clay — None. 

Clel>ume — S. L. Williams, Hightower. 
Coffee— V. T .Fleming, Bnterprise; H. R. Bradley, Elba. 
Colbert — ^None. 

Conecuh — ^W. P. Betts, Evergreen. 
Covington — ^None. 
Crenshaw — ^None. 
Cullman — ^John Yielding, Walker. 
Dale — ^F. R. Yarborough, Ozark. 

Dallas — ^B. B. Rogan, Selma; J. H. Keyser, Richmond. 
DeKalb — ^E. P. Nicholson, Valley Head. 
Elmore — H. E. Scott, Wetumpka. 

Escambior—'R. A. Smith, Hammac; W. L. Abemathy, Flomaton. 
Etowah — E. T. Camp, Gadsden. 
Fayette — ^V. Savage, Pilgrim. 
Franklin — E. M. Harris, RussellviUe. 
Greene — ^None. 

Geneva — ^M. F. Fleming, Geneva. 
Hale — M. C. Qtts, Greensboro. 

Henry — ^W. M. Ryals, Co warts; J. R. G. Howell, Dothan. 
Jackson — T. E. Callan, Scottsboro. 

Jefferson — Edgar A. Jones, Birmingham; L. C. Morris, Birmingham. 
Lamar — D. D. Hollis, Sulllgent 
Lauderdale — ^A. Zimmerman, Killen. 
Lawrence — ^None. 
Lee — ^None. 
Limestone — ^None. 
Lowndes — ^None. 
Macon — J. B. Letcher, Shorters. 

Madison — J. T. Haney, Madison; E. O. Williamson, Gnrley. 
Marengo — C. B. Thomas, Thomaston; J. S. Skinner, Shiloh. .y 

Marion — C. L. Woods, Hamilton. 
Marshallr—T, A. Casey, Albertville. 
Mobile— 1, T. Inge, Mobile; G. H. Fonde, Mobile. 
Monroe— Vf, J. Mason, Activity. 

Montgomery— lA, B. Kirkpatrick, Montgomery; S. A. Billing, Mont- 
gomery. 
Morgan — ^None. 

Perry— Edward Swan, Sprotts. 
Pickens — ^None. 
Fike—J, W. Robertson, Brundldge. 






MEMBERS. 



147 



Randolph— J. W. Hooper, Roanoke. 

Russell— ^. P. NorrlB, Uhland. 

Bhelby—B. C. Parker, Shelby; B. O. Glykan, HontOTallo. 

St. Ctoir— None. 

Sumter— J. P. Scales, Coatopa; J. H. Reed, Bpps. 

Talladegor-B, B. Sims, Talladega; P. H. Craddock, Sylacauga. 

Tiaiapoosa—B^. W. Hart, Walnut Hill. 

Tuscaloosor-Yi, M. Faulk, Tuscaloosa; M. L. Mallory, Tuscaloosa. 

Walker— J. M. Miller, Cordoya; J. N. Odom, America. 

Wilcox — ^None 

Winston— l^one. 





uBUBBRS. 




NAME. 


BESIDBKGE 


COUNTY. 


Barron, W. H. 


Scotts Station 


Perry. 


Bankston, R. C. 


Birmingham, 


Jefferson . 


Bonner, T. H. 


Hickory Plat, 


Chambers. 


Baker, J. N. 


Montgomery, 


Montgomery. 


Bussey, J. P. 


Jones Mill, 


Monroe. 


Byrd, B. L. 


Daleville, 


Dale. 


Burroughs, W. M. 


Pine Hill, 


Wilcox. 


Gains, V. H. 


Safford, 


Dallas. 


Copeland, B. O. 


Birmingham, 


Jefferson. 


Coleman, R. M. 


Eleanor, 


Dallas. 


Dahlberg, C. I. 


Suggsville, 


Clarke. 


Donald, E. G. 


Monterey, 


Butler. 


Driver, B. N. 


Newbeme, 


Hale. 


Duggar, L. L. 


Fairford. 


Washington. 


DuBose, W. S. 


Columbiana, 


Shelby. 


Edwards, D. B. 


Polk, 


Dallas. 


Edwards, J. H. 


Wylam, 


Jefferson. 


Fuller, B. L. 


Summerfleld, 


Dallas. 


Gtordon, S. A. 


Collirene, 


Lowndes. 


Glass, B. T. 


Birmingham, 


Jefferson. 


Gee, B. T. 


BumsYille, 


Dallas. 


Hixson, P. P. 


Perote, 


Bullock. 


Hudson, W. H. 


LaPayette, 


Chambers. 


Harper, W. W. 


Selma, 


Dallas. 


Hestle, W. M. 


Buena Vista, 


Monroe. 


Hawthorne, S. M. 


Pine Apple, 


Wilcox. 


Jones, T. W. 


Camden, 


<• 


Joiner, W. T. 


Russell, 


Mobile. 


Jenkins, L. A. 


Cardiff, 


Jefferson. 


Jeltries, J. G. 


Whatley, 


Clarke. 


Kimbrough, W. L. 


Linden, 


Marengo. 


ELlrkpatrick, S. 


Selma, 


Dallaa. 



148 



THE MEDICAL ASSOCIATION OF ALABAMA. 



VAME. BE8IDENCS OOUNTT. 

Kennedy, J. O. Kennedy, Lamar. 

Klmbrous^h, F. F. Jr. Arlington, Wiloox. 

Lockhart, W. C. Dayton, Marengo. 

Lockhart, T. B. Selma, Dallas. 

Leonard, M. W. Cedarville, Hale. 

Lightfoot, P. M. Cross Keys, Macon. 

LeBarron, Yellow Pine, Washington. 

Lewis, B. J. Fresco, Ck>ffee. 

McWhorter, H. P. Collinsyille, DeKalb. 

Montgomery, A. H. Montgomery, Montgomery. 

Mobley, R. V. Birmingham, Jefferson. 

Moore, J. T. Ornrille, Dallas. 

May, J. T. Notasulga, Macon. 

Morris, L. C. Birmingham, Jefferson. 

Matthews, B. A. Clanton, Chilton. 

Mayer, Lower Peach Tree, Wilcox. 

Mason, W. J. Activity, Monroe. 

Mosely, D. C. Faunsdale, Marengo. 

Martin, T. M. PlantersYille, Dallas. 

Purifoy, J. H. Furman. Wilcox. 

Peters, U. J. W. Birmingham, Jefferson. 

Persons. H. S. Montgomery, Montgomery. 

Pegues, e. L Safford, Dallas. 

Rogers, Mack Birmingham, Jefferson. 

Rea. B. F. Coosada, Blmore. 

Robinson, L. D. Montgomery, Montgomery. 

Stubbs, G. H. Birmingham, Jefferson. 

Sadler, W. F. Montgomery, Montgomery. 

Sims, C. T. Gadsden, Btowah. 

Somerville, W. G. Tuscaloosa, Tuscaloosa. 

Smith, S. D. Demopolis, Marango. 

Shivers, O. L. Marion, Perry. 

Sellers, I. J. Birmingham, Jefferson. 

Sellers, Wm. Thos. Browns, Dallas. 

Whitfield, S. T. Unlontown, Perry. 

Wilkinson, D. L. Montevallo, Shelby. 

Wilson, I. G. Demopolis, Marengo. 

Ward, B. B. Selma, Dallas. 

SUMMARY 

Grand Senior Life Counsellors 4 

Grand Senior Counsellors 18 

Senior Counsellors 20 

Junior Counsellors. 15 

Delegates 63 

Members 70 

Total registered attendance ,,,,,,,.,,, 190 



THE ANNUAL REGISTER 

OF THS 

MEDICAL ASSOCIATION 

OF THB 

STATE OF ALABAMA. 



THE BOOK OF THE ROLLS OF THE MEDICAL ASSOCIATION 

OF THE STATE OF ALABAMA. 



IKTBODUCTION. — OF LBOAL IMPOKTANCE TO XyEBT PHYSICIAN IN 

THS STATE OF Af.ARAlffA. 

Owing to the legal relations which each member of each county 
medical society bears to the State of Alabama (which relations are 
set forth In the Code of the State) , It Is absolutely necessary that the 
presidents, secretaries, treasurers, members of the boards of cen- 
sors, and each Individual member of the societies, should see that 
the roster of their respective societies is sent to the Secretary of the 
State Association In accordance with the specific Instructions, print- 
ed on the blanks sent to the secretary of each society. 

It is, therefore, urged upon the officers of each county medical 
society to see that, In future, the reports be properly filled out in 
accordance with the printed instructions on the blank. It is advised 
that the secretaries compare their reports for the current year with 
the report, as printed in the volume of Transactions for the previous 
year and that all the changes be carefully made. 

A strict compliance with the instructions printed on the blank for 
report will avoid all difficulties. 

Explanation. — The letters "mc" stand for "medical college;" the 
letters "cb" for "county board;" when the certificate is Issued by the 
examining board of the county in the register of which it occurs, 
the name of the county Is omitted; when the certificate was Issued 
by the examining board of some other county, the name of such 
county succeeds the abbreviation. The first name of every board of 
censors Is that of the president of the board. The letters "ng" stand 
for "non-graduate." "Diploma recorded" applies to a small number 
of doctors, who are exempt from criminal prosecution, but who are 
illegal doctors. 



150 THE MEDICAL ASBOCIATIOS OF ALABAMA. 

THE ROLL OF THE COUNTY MEDICAL SOCIETIES. 

REVISION OF lOOl. 

AUTAUGA COUNTT MEDICAL. SOCIETT— SdBW. U74. 



Pretident, C. Rice; Tico-Prestdent. H. D. Smith; SwrataiT. R- H. 
Davis; Treamrer, B. H. Darla; BealUi OOnr, J. W. Ha^ar. 
Couon— R. H. DaTia^ a Rioe, M. D. Smith. J. W. Hauler, J. K. 
WUklnaon. 

HUUS or ^rwtMuna WITO THKtB qHJ-WM Am rOSKMrVO^ 

Davis, Robert Herritt, mc nnlT Tnlans 95, di 95, PrattriUa. 
Davis, Blbert HorUn, mc Chattanoosa IMW, cb 1900, Hn<^abe& 
Hauler, John Wiley, mc Alabama 94, Ot Tnaolooaa 94, PrattrUl& 
Marlar, Alonxa, Jr., mc Alabama 94. cb Tiucalaan 94. Billingsleir. 
Rice. Clarance. mc Alabama 9S, eb 9S. Prattrllla. 
Smith. Malcolm Daniel, mc nnlv New York 91. cb Coosa 91. PrMtville. 
Snow, J. Louis, mc Alabama — . cb Lowndes 91, Aatangavllie. 
Thompaon, Hallett Webster, mc oalv Ta]«ne 100, cb 1900. BiiUngB- 

lej. 
Wilkinson, John Bdwud, sue oniv Tulane, C8. d> SO, Pnttville. 
Total, 9. 

PKTSICUJfS ROT UEMBEBS OF TBC SOCnTT. 

Davis, John WilUam, mc Atlanta S9. cb 80, PrattviUe. 

Gibson. William Beatty, mc Bellevue 89, State Board 92. Autauga- 

TlUe. 
Oolson, W;aU Washington, mc Soath Carolina S4, cb 84, Inde- 
pendence. 
Oolson. Robert Marion, mc unlv Tennessee 94, cb 94, Independence. 
Total, 4. 
" — ■■ Into the county — J Lonls Snow,rrom Farmereville, Lowndes 
to AutaugaviUe. 

out of the connty — John Edward Wilkinson, Jr., trom Pratt- 
Brierileld, Bibb county. 

[nations — Hallett W. Thomiuon, Tulane 1900, certlUcate 
John Bdward Wilkinson, unir of the South 1901. certiflcftte 
Blbert Horton Downs, Chattanooga mc 1900, certlflcste 

— Cbaa. Alva Edwards, PrattviUe. 



fB£ ROLL 0^ T^E COUlfTT BOOtBTtSB. \^\ 

BALDWIN COUNTY MEDICAL SOCIBTY— Annistoii, 1886. 

OniOEBS. 

PreBideut, P. M. Hodgson; Vice-PreBident, C. L. Merahon; Secre- 
tary, v. McR. Scho waiter; Treasurer, V. McR. Scho waiter; Health 
Officer, v. McR. Schowalter. Censors — P. M. Hodgson, C. L. Mer- 
shon, John H. Hastie. 

NAMES or MEMBKB8 WITH THKIB COLLBOBB AND POSTOVllOIB. 

Hall, R. A., mc univ Tennessee 94, cb 1901, Falrhope. 

Hall, Joseph, mc Alabama 1901, cb 1901, Daphne. 

Hastie, John Hamilton, mc univ Tennessee 99, cb 99, Stockton. 

Hodgson, Phillip M., mc Atlanta 89, cb Monroe 89, Stockton. 

Howe, Charles Lester, mc Kentucky S. of M. 93, cb 93, Magnolia. 

Lambert, George Lee, mc Alabama 95, cb Choctaw 95, Bay Minette. 

Loyelady, William Marshall mc , cb 86, Bon Secour. 

McLeod, J. C, mc Birmingham 1900, cb Coosa 1900, Dolive. 
Mershon, Clarence L, mc Iowa 98, cb 99, Fairhope. 
Schowalter, Volney McR, mc Alabama 90. cb 90, Point Clear. 
Trammell, Joseph D., mc univ Nashville 57, cb 86, Bay Minette. 
Total, 11. 

PHYSICIANS NOT MEMBEBS OF THE BOCIETl. 

Coghlan, Malachy, mc Alabama 92, cb 92, Tensaw. 

Davis, T. A., mc , cb — , Daphne. 

Total, 2. 

Moved into the county — R. A. Hail, from Louisiana to Fairhope. 
Moved out of the county — W. O. Aikin, from Stockton to Florida. 

BARBOUR COUNTY MEDICAL SOCIETY— Buf aula, 1878. 

President, W. P. Copeland; Vice-President, J. J. Winn; Secretary, 
H. L. Brannon; Treasurer, W. O. Lewis; Health Officer, W. H. Rob- 
ertson. Censors — ^H. L. Brannon, B. F. Bennett, W. P. Copeland, 
W. H. Robertson, J. J. Winn. 

NAMES OF MEMBEBS WITH THEIB C0LLBQE8 AND FOSTOFHaiS. 

Battle, Junius Kincade, mc univ Louisiana 83, cb 83, Eufaula. 
Bennett, Benjamin Franklin, mc Alabama 93, cb 93, Louisville. 
Brannon, Henry Lee, mc univ Vanderbilt 86, cb 86, Eufaula. 
Britt, Walter Stratton mc Bellevue 98, cb Bullock 98, Eufaula. 
Copeland, William Preston, mc Bellevue 70, cb 79, Eufaula. 



152 ^^^ MEDICAL ASSOCIATION OF ALABAMA. 

Davie, Judflon, mc Georgia 72, cb 81, Cowikee. 
Hagood, John Waller, mc Alabama 98, cb Lowndes 98, Alston. 
Harrison, William Henry, mc Chattanooga 93, cb 93, Baker Hill. 
Houston, James LaFayette mc uniy Vanderbilt 98, cb 98, Harris. 
Lewis, William Gabriel, mc Atlanta 84, cb Henry 84, Eufaula. 
Mangum, William Weightman, mc Atlanta 83, cb Butler 93, Eufaula. 
McDowell, William P., mc Alabama 1900, cb 1900, Glajrton. 
Mitchell, William Augustus, mc univ Louisiana 68, cb 86, Eufaula. 
Patterson, Thomas, mc Atlanta 69, cb 82, Louisville. 
Robertson, William Henry, mc Alabama 87, cb 87, Clayton. 
Smart, William Alpheus, mc Louisville 83, cb Coffee 83, Clayton. 
Wallace, George Oscar, mc Alabama 91, cb 91, Clio. 
White, Robert Lee, mc Alabama 98, State Board 98, Mt Andrew. 
Winn, Locke Minor, mc univ Tulane 1900, State Board 1900, Clayton. 
Winn, James Julius, mc Atlanta 68, cb 81, Clayton. 
Total, 20. 

PHYSICIANS NOT MSMBi£BS OF TKB SOCIETT. 

Faulk, Daniel Winston, cb 84, Clio. 

Gilbert, Andrew Jackson, mc Atlanta 89, cb Russell, 89, Eufaula. 
Herron, Darrell JefFerson, mc Atlanta 83, cb 83, Louisville. 
Mclnnis, James A., mc Memphis Hospital 96, cb 99, Clio. 
Mitchell, Thomas Snead, mc Atlanta 66, cb Lee 83, Eufaula. 
Patterson, Robert B, mc Atlanta 99, cb 99, Louisville. 
Wilson, Cato Hadras (col.) mc Meharry 99, cb 99, Eufaula. 
Total, 7. 

Retired— Q. W. Huey, Baker Hill. 

Moved into the county — ^W. H. Harrison, from Talladega county to 
Baker Hill; W. W. Mangum, from Georglana, Butler county, to Eu- 
faula. 

Moved out of the county — J. C. Borders, from Louisville to Louisi- 
ana; J. H. Lingo, from Texasville to Dundee, Geneva county; J. H. 
Pruett, from Harris to Midway, Bullock county. 

ESzaminations — ^W. P .McDowell, mc Alabama 1900, certificate 
granted; C. H. McDonald, mc Alabama 1900, certificate refused. 

Deaths — Albert Goodwin, Eufaula; C. H. McDonald, Clio. 
BIBB COUNTY MEDICAL SOCIETY— Montgomery, 1875. 

OFXICEBS. 

President— W. H. Bell; Vice-President, J. F. Curtis; Secretary, 
P. I. Hopkins; Treasurer, T. E. Schoolar; Health Ofiicer, J. S. 
Moore. Censora— W. H. Bell, A. E. Meadow, L. E. Peacock, J. 
F. Curtis, T. E. Schoolar. 



THE ROLL OF THE COUNTY BOOIETIES. 163 

NAMB8 or TUmniKBfl WITH THUS OOLLBOBS AHD VOBT^miaBi. 

Bell, Walter Howard, mc Atlanta 88, cb Calhoun 88, Harsroye. 

Campbell, Charles Monroe, mc univ Tennessee 94, cb 94, Scottsrille. 

Curtis, Joseph Franklin, mc Alabama 93, cb Shelby 93, Blocton. 

Cannon, Daniel Pugh, mc Vanderbilt — , cb 95, Corlina. 

Hopkins, Perry Isaaih, mc uniy Vanderbilt 99, cb 99, CentreviUe. 

Jones, Rufus C, mc Montezuma 98, cb Shelby 98, Blocton. 

Krout, Chas. Franklin, mc Alabama 95, cb 95, Pondville. 

Meadow, Albert Eli, mc Pulte 83, cb Jefferson 83, Blocton. 

Miller, J. T., mc univ Vanderbilt 86, cb Pickens 86, Lopez. 

Moseley, David Orian, mc Washington 72, cb Perry 78, CentreylUe. 

Moore, James Samuel, mc Phys. and Surg. Baltimore 93, cb Jeffer- 
son 93, Six Mile. 

Nicholson, Wm. John, mc Vanderbilt 84, cb 86, Six Mile. 

Peacock, Lovick Edward, mc Alabama 92, cb Marengo 92, Blocton. 

Ray, Jacob Usry, Jr., mc univ Tennessee 93, cb 93, Blocton. 

Schoolar, Milton Carson, mc Alabama 87, cb 87, CentreviUe. 

Schoolar, Thornly Edward, mc univ Vanderbilt 92, cb 92, CentreviUe. 

Thomas, M. C, mc Tulane 99, cb 99, Lopez. 

Trigg, Allen Warren, mc Alabama 81, cb Tuscaloosa 81, Blocton. 

Woolley, Chas. Lewis, Old Law, 69, cb Perry 79, Randolph. 
Total, 19. 

HONOBABT MEMBER, 

James Wilford Williams, mc Georgia &9, cb 79, CentreviUe. 

PHYSICIANS NOT MEMBEBS OF THS SOCIETY. 

Adams, J. Bird, mc Alabama 97, cb 97, Lawley. 

Buntin, William Battle, mc Memphis Hospital 1900, cb 1900, Scotts- 

ville. 
Owens, John Harrison, mc Memphis Hospital 99, cb, 1900, Scottsville. 
Steward, Charles Franklin, mc Alabama 91, cb 91, Jericho. 

Total, 4. 

Moved into the county — John H. Owens, from Havana, Hale coun- 
ty, to Scottsville; William Battle Buntin, from Meridian, Miss., to 
Scottsville; Perry Isaaih Hopkins, from Bessemer to Centervllle; D. 
P. Cannon, from Coaling, Tuscaloosa county, to Coalina; J. E. Wil- 
kinson, Jr., from Prattville to Brierfleld. 

Examinations — ^Albert M. Woolley, mc Alabama 1900, certificate 
granted; J. H. Owen, Memphis Hospital 99, certificate granted; Chas. 
P. Martin, mc univ Vanderbilt 1900, certificate granted; Wm. Battle 
Buntin, mc Memphis Hospital, 1900, certificate granted. 

DeathB— J. U. Ray, Sr., Woodstock; John Wesley Jones, Randolph. 



154 ^^^ MEDICAL ASSOCIATION Or ALABAMA. 

BLOUNT COUNTY MEDICAL SOCIETY— Mobile, 1876. 



President— W. B. Allgood; Vice-Presideiit, D. 8. Moore; Secretary, 
IL E. Mitchell; Treaeurer, H. E. Mitchell; Health Officer. F. N. Hud- 
soiL Censors— F. N. Hudson. W. T. Bains, H. E. Mitchell, E. S. W. 
Cox, W. B. Allgood. 

STAMXS or MEMBERS WITH THEIB OOfJJPBIW AITO POSI^OVnCBL 

Allgood, William Benton, mc Atlanta Southern 78, cb 78, Chepnltepec. 
Bains, William Talley, mc uniT Vanderbilt 88, cb 88, Cleveland. 
Cox, Edward S. W., mc uniy Tennessee 93, cb 93, Bangor. 
Gillespie, Felix Augustus, mc Alabama 89, cb 89, Hanceville. 
Gillespie, William Thomas, mc Chattanooga 98, cb 98, McLarty. 
Hudson, Frank Norton, mc uniT Vanderbilt 74, cb 76, BlountsYille. 
Mitchell, Henry Eugene, mc uniT Vanderbilt 93, cb 93, Oneonta. 
Moore, Darid Sanders, mc Atlanta 80, cb 80, BlountsviUe. 
Total, 8. 

PHYSICIANS NOT MEMBERS OF THE 80CIETT. 

Alridge, Patrick George, mc Atlanta Southern 76, cb 79, BrooksriUe. 
Armstrong, Jesse Isom, mc Chattanooga 93, cb 93, Blount Springs. 
Brown, Jesse, mc Memphis Hospital 1900, cb 1900, Clarence. 

Berrier, J. H., , Oneonta. 

Cole, William M., mc Atlanta 86, cb 86, Blountsville. 
Davidson, Alvin Steele, ng, cb 71, Selfrille. 
Donehoo, Floyd G., mc Atlanta Southern 81, cb — , Oneonta. 
Gibbs, U. M., mc uniT NashTille 98, cb 1900, Hanceville. 
Haden, Andrew Wade, mc univ Vandervilt 82, cb 82, Summit 
Leach, James Edward, mc uniy Nashville 1900, cb 1900, Liberty. 
Martin, William H., mc AtlanU 88, cb Cullman 88, Hanceville. 
Mcpherson, George Willis, mc univ Tennessee 87, cb Cullman 87, 

Country. 
Self, George Washington, mc univ Tennessee 89, cb 89, Selfville. 

Total, 13. 

Moved into county — Cole, William M., from Texas to Blountsville; 
William H. Martin, from Cullman county to Hanceville. 

Moved out of county — P. M. Baker, from Snead to Boaz, Marshall 
county; J. G. Chambers, from Liberty to Woodlawn, Jefferson coun- 
ty; J. T. Harwell, from Compton to Dolomite, Jefferson county; H. 
C. Bumum, from Swansea to Chalkville, Jefferson county; W. H. 
Haden, from Summit to Cullman county; W. T. Hinds, from Sum- 
mit, to Arab, Marshall county; M. S. Ingram, from Hanceville to 
Brighton, Jefferson county; H. B. Martin, from Arkadelphia to Avon- 



THE ROLL OF THE COUNTY BOOIETIEB. I55 

dale, Jefferson coanty; J. H. Martin, from Oneonta to Sprlhgrllle, 
St. Clair county; H. B. Martin, from Arkadelphia to Cordova, Wal- 
ker county; W. M. Finley, from Blountsvllle to Birmingham; J. L. 
Rains, from Liberty to Texas; W. L. Roseman, from Arkadelphia to 
E«n8ley, Jefferson county; J. C. Walker, from Clarence to Mary lee. 
Walker county; Henry S. Ward, from Oneonta to Birmingham; P. 
Whaley, from HanceviUe to Marion county. 

ESxaminations — ^Jesse Brown, Memphis Hospital mc 1901, certifi- 
cate granted; U. M. Oibbs, univ Nashville, 1898, certificate granted; 
W. T. Gillespie, Chattanooga, mc 1898, certificate granted; J. B. 
Leach, uniy Nashville, 1900, certificate granted; J. C. Walker, univ 
Nashville 1900, certificate granted. 

Death — Clapp, William King, Gum Springs. 

BULLOCK COUNTY MEDICAL 80CIBTY— Selma, 1879. 

President, Seale Harris; Vice-President, F. P. Hixon; Secretary, C. 
M. Franklin; Treasurer, S. C. Cowan; Health Oflicer, Seale Harris. 
Censors — C. H. Franklin, Seale Harris, R. H. Hayes, S. C. Cowan, 
C. M. Franklin. 

KAMES OF MEMBKRa WITH THEIB COLLEGES AND FOST-OFTIOES. 

Baldwin, James Crews, mc Richmond 94, cb Macon 94, James. 
Boswell, Frank B., mc Alabama 1900, cb Pike 1900, Post Oak. 
Bowman, James L., mc univ of Virginia — , cb 1901, Union Springs. 
Butt, Richard Lemuel, mc univ New York 46, cb 80, Midway. 
Cowan, Samuel Calvin, mc Alabama 89, cb 89, Union Springs. 
Darnell, Benjamin Franklin, mc Atlanta 56, cb 83, Fitzpatrick. 
Dean, T. Joseph, mc Louisville 94, Chambers 94, Union Springs. 
Eidson, James Thomas, mc Alabama 94, cb 94, Fitzpatrick. 
Franklin, Charles Higgs, mc Louisiana 66, cb 80, Union Springs. 
Franklin, Charles Moore, mc phys and surg New York 98, cb 98, 

Union Springs. 
Guthrie, George Martin, mc Alabama 1900, cb 1900, Inverness. 
Harris, Seale, mc univ of Virginia 94, cb 94, Union Springs. 
Hayes, Robert Hughes, mc St. Louis 79, cb 80, Union Springs. 
Hixon, Frank Petty, mc univ Vanderbilt 98, cb 98, Perote. 
Hunter, Henry Mitchell, mc phys and surg Baltimore 86, cb 87, 

Union Springs. 
Martin, Henry Marcellus, mc univ of Virginia, State Board 1900, 

Union Springs. 
Pruett, James Henry, mc univ New York 58, cb 79, Midway. 
Reynolds, William Henderson, mc Alabama 85, cb 85, Union Springs. 



156 ^^^ MEDICAL ASSOCIATION OF ALABAMA. 

Oami aam, UeweUen, mc GSeoisiA 4S, db 87, Union SpringK. 
Walker, William Anfltin, mc Jefferaon 54, cb 80, Perote. 
Total, 20. 



^ 



PHT8ICIAX8 XOT IfK i iBWW OT THK 80CIRT. 

Allen, Alexander George William (col), mc Meharry 99, cb Roasell 

99, Union Springs. 
Williama, Anderson Milton (col), mc Leonard 1900, cb 1900, Union 

SpringB. 

Total, 2. 

Moved into the county — ^Henry Marcellus Martin, from Atlanta to 
Union Springs; F. B. Boswell, from Pike county to Poet Oak; J. L. 
Bowman, from Virginia to Union Springs. 

Moved out of the county — ^Jamee William Beasley, from Mt Bil- 
liard to Pike county. 

E:xamination»— Ctoorge M. Guthrie, mc Alabama 1900, certificate 
granted; A. M. Williams (col), mc Leonard 1900, certificate granted; 
J. L. Bowman, mc uniy of Virginia, certificate granted. 

Deaths— Augustus Clayton Crymes, Midway; William Bartlett 
Thomason, Aberfoil. 

BUTLER COUNTY BfEDICAL SOCIETY— Montgomery. 1875. 

ovncBBS. 

President, R. E. Smith; Vice-President, J. C. Watson; Secretary 
T. D. Stallings; Treasurer, T. D. Stallings; Health Ofllcer, J. C. 
Kendrick. Censors — J. C. Kendrick, E. G. Donald, T. D. Stallings, 
J. A. Kendrick, J. C. Watson. 

NAMES OF MEMBEBS WITH THEIB 00LLBGB8 AND F06TH>FFICES. 

Allman, James Edward, mc Savannah 69, cb 79, Oeorgiana. 
Broughton, John Thomas, mc uniy Pennsylvania 62, cb 79, Greenville. 
Donald, Erskine Grier, mc Alabama 93, cb 93, Monterey. 
Garrett, James Jefferson mc Georgia Reform 82, cb 82, Forest Home. 
Kendrick, Joel Cloud, mc univ Nashville 52, cb 78, Greenville. 
Kendrick, John Aaron, mc univ Tulane 94, cb 94, Greenville. 
McCaine, James Jordan, mc univ Tulane, 82, cb 82, Chapman. 
Morris, William Eli, mc Alabama 97, cb Conecuh 97, Georgiana. 
Perdue, James Lewis, mc Alabama 76, cb 79, Greenville. 
Smith, Robert Edward, mc Alabama 82, cb 88, Greenville. 
Stallings, Thomas Daniel, mc Alabama 89, cb Lowndes 89, Greenville. 
Thaggard, Robert Albert, mc univ Tulane 97, cb 97, Greenville. 
Wall, Richard Albert, mc univ Tulane, 92, cb 94, Forest Home. 
Watson, James Crawford, mc Alabama 98, cb 98, Georgiana. 
Total, 14. 



THE ROLL OF THE COUNTY BOOIBTJES I57 

PHTSICIAlf 8 ITOT MKHBEB8 OV THB SOCimr. 

TiUeiT, L. S. mc, cb 84, Ft Deposit, Lowndes county. 
Seimmes, W. C, mc — , cb 78, Manningham. 
Total, 2. 

Moved out of the county — ^Herbert F. Saunders, from Greenville to 
U. S. army; Henry Green, from Boiling to Dothan, Henry county; 
W. W. Mangum, from Georglana to Eufaula, Barbour county; Wil- 
liam Abner Brown, from Garland to ^. 

Death — ^William Paners Grlssett, of consumption, Garland. 
CALHOUN COUNTY MEDICAL SOCIETY— Montgomery, 1881. 

OinCKRS* 

President, B. C. Anderson; Vlve-Presldent, W. H. Klnnebrew; Sec- 
retary A. A. Greene; Treasurer, E. C. Anderson; Health Officer, J. 
M. Whiteside. Censors— W. A. Smith, J. M. Whiteside, W. B. Ar- 
berry, J. F. Walker, W. H. Klnnebrew. 

NAMES OF MBMBEB8 WITH THSIB OOLLBOSS AUD FOSTOmOBB. 

Anderson, Edmond Clack, mc Kentucky s of m 77, cb 85, Annlston. 

Arberry, William Buchanan, mc unly Vanderbllt 82, cb Macon 82, 
Jacksonville. 

Bowcock, Robert Lee, mc unlv Virginia 86, cb 88, Annlston. 

Brock, Jefferson C, mc unlv Vanderbllt 84, cb Randolph 84, Annlston. 

Brouthers, Phillip Houston, ng (old law) 41, cb 86, Zula. 

Davis, John Francis Marlon, mc Atlanta 60, cb 80, Choccolocco. 

Douthlt, Andrew Jackson, ng (old law), cb 81, Alexandria. 

Gordon, Frederick Elliott, mc Alabama 82, cb Marengo 82, Annlston. 

Greene, Allen Augustus, mc unlv Vanderbllt 81, cb Chilton 91, An- 
nlston. 

Hamilton, C. J., mc , cb 

Hughes, Robert Lee, mc Atlanta 92, cb 92, Choccolocco. 

Kelly, John Baker, mc Jefferson 59, cb Coosa 84, Annlston. 

Klnnebrew, William Henry, mc unlv New York 78, cb 83, Piedmont. 

Ligon, Arthur Wellington, mc unlv Vanderbllt 83, cb Cleburne, 84, 
Oxford. 

Meharg, Shelton Theodore, mc Memphis Hospital 1900, cb 1900, 
Weavers. 

Moon, Edward Klmbrough, mc unlv Grant 92, cb Marshall 92, An- 
nlston. 

Smith, William Armstead, mc Alabama 81, cb Monroe 81, Annlston. 

Steele, Abner Newton, mc Alabama 90, cb Pickens 90, Annlston. 

Taylor, James Ratchford, mc Atlanta 80, cb Clay 96, Annlston. 



158 ^^^ MEDICAL ASSOCIATION OF ALABAMA. 

Vann, Paul D., mc Alabama 96, cb DeKalb 96, Anniston. 
Walker, James Fleming, mc unlv Louisville 92, cb 92, Anniston. 
Whiteside, John Mclntyre, mc uniy Vanderbllt 84, cb 84, Oxford. 
Total, 22. 

HONOBABY MEMBBBB. 

Robertson, Thaddeus Lindley, mc Jefferson. 61, cb 81, Birmingham. 
Warren, William James, mc Atlanta 89, cb Tallapoosa 89, Anniston. 
Wikle, Jessie Lane, (Druggist), mc Oeorgia 71, cb 81, Anniston. 
Williams, Genaboth Gape, ng, 81, White Plains. 
Total, 4. 

PHYSICIANS NOT MEMBEB8 OF THE SOCIETY. 

BuUard, Francis Aurelius, ng, cb 81, Oxford. 

Grook, John E., mc uniy Vanderbilt — , cb 81, JacksonyiUe. 

Edmondson, A. J., mc Atlanta, Anniston. 

Hudson, T. H., mc Alabama, cb — , DeArmanyille. 

Huger, Richard Proctor, mc South Garolina 71, cb 81, Anniston. 

Hughes, John Leander, mc Georgia 51, cb 83, Piedmont 

Koch, J. J., ng, illegal, Bruner. 

Matthews, George Andrew, mc uniy Michigan 66, cb 80, Anniston. 

McGreary, Samuel Josephus, mc Atlanta 80, cb Cherokee 81, Anniston. 

Meharg, William Gray, mc Memphis Hospital 99, cb 99, 

Pruitt Eber Austin, mc Alabama 1900, cb 1900, 

Thomas, Charles E. (col), mc Long Island Hospital 90, cb 90, An- 
niston. 

Teague, Francis Bowden, mc uniy Tennessee 80, cb Etowah 80, Pied- 
mont. 

Whiteside, John U., mc Alabama 96, cb 96, White Plains. 

Williams, Benjamin Dudley, mc uniy Louisyille — , cb 87, Oxford. 

Williamson, Thomas ng, cb 84, Peeks Hill. 
Total, 16. 

Moyed into the county — C. J. Hamilton, C. C. McClintock, A. E. 
Pruett, W. G. Meharg, J. J. Koch. 

Moyed out of the county — ^T. W. Ay res, from Anniston to China 
as medical officer U. S. A.; W. M. Turner, from Anniston to parts 
unknown; A. W. Bell, from Weayers to Vifioents, Shelby county; 
G. L. Chapman, from Alexandria to Georgia; A. J. Sanders, from 
Ohatchee to Jefferson county. 

Examinations — ^Amzl Jones, Vanderbilt 1900, certificate granted; 
Shelton Theodore Meharg, Memphis H. M. C, 1900, certificate 
granted; Eber Austin Pruett, mc Alabama, 1900, certificate granted. 



THE ROLL OF THE COUNTY B00IETIB8. 159 

•CHAMBERS COUNTY MBDICAL SOCIETY— Montgomery, 1881. 

OJTIUEBS. 

President, Z. T. Grady; Vice-President, W. J. Love; Secretary, W. 
D. Gaines; Treasurer, W. D. Gaines; Health Officer, W. M. Gay. Cen- 
sors— W. D. Gaines, W. H. Hudson, W. J. Lore, T. H. Bonner, T. 
H. Haralson. 

ITAIOS OF MKMBEBS WCTH THKIB OOLLBOES AJTD F08TO1TI0I8. 

Bonner, Thomas Hamilton, mc Southern 84, cb Randolph 84, Hickory 

Flat. 
Finley, Emmett M., mc Atlanta 80, cb 96, Fredonia. 
Gaines, William D., mc Alabama 92, cb 92, LaFayette. 
Gay, William M., mc Southern — , cb Randolph — , Penton. 
Grady, Zachary Taylor, mc Atlanta 80, cb 81, LaFayette. 
Haralson, Thomas H., mc Memphis Hospital 99, cb 99, Cusseta. 
Hilt, John Leonard, mc Southern 89, Jefferson 89, Five Points. 
Hudson, William Henry, mc Atlanta 86, cb 86, LaFayette. 
Ison, Josiah Allen, mc Southern 87, cb Tallapoosa 87, Wise. 
Liles, John P. mc Birmingham 98, cb 98, Mill Town. 
Love, William Joseph, mc Atlanta 82, cb Lee 86, LaFayette. 
Newman, Samuel Harris, mc Memphis Hospital 98, cb 98, West 

Point, Ga. 
Rutland, John Blake, mc univ Nashville 55, cb 82, West Point, Ga. 
Thompson, James F., mc univ Georgia — , 98, Langdale. 

Total, 14. 

Honorary Members 

Griggs, Asa Wesley, mc univ Nashville 56, cb 82, West Point, Ga. 
Rea, Benjamin Franklin, Sr., mc Jefferson 42, cb 82, LaFayette. 
Smith, Lawrence, mc Georgia 52, cb 82, Cusseta. 

PHTBICIANB NOT MEMBEB8 OV THS BOCIETT. 

Carmichael, Lawrence Greer, mc Graffenburg 67, cb 82, Strand. 

Chambers, , , cb 96, Langdale. 

Coleman, Hiram F., mc Southern — , cb — , Strand. 
Davis, James Lawson, mc Alabama — , cb 82, LaFayette. 
DeVaughan, John Wesley, mc Vanderbilt 83, cb 83, Mill Town. 
Grady, J. Lorenzo, mc Atlanta 95, cb 96, Fredonia. 

Hamner, Lovic Pierce, mc , cb Randolph 82, Five Points. 

Hodges, Wyatt T., mc Alabama 92, cb 97, River View. 

Millford, H. H., mc , cb Lee — , Five Points. 

Striplin, , mc , cb — , Fredonia. 

Total, 10. 
*NoTB — As no report has been received from Chambers county this 
year, the report of 1900 is herewith produced. 



130 THE MEDICAL ASSOCIATION OF ALABAMA. 

CHEROKEE COUNTY MEDICAL SOCIETY— Tuscaloosa, 1897. 

0JT1CE88* 

President, H. L. Ison; Vice-PFesident, S. C. Tatum; Secretary, R. 
L. McWhorter; Treasurer, A. C. Shamblin; Health Officer, H. L. 
Appleton. Censors — ^A. C. Shamblin, H. L. Ison, S. C. Tatum, H. 
L. Appleton, R. L. McWhorter. 

NAMES OF MEMBEBS WPTH THEIB COLLEGES AND POST-OFFICES. 

Appleton, Hugh Lowndes, mc uniy Vanderbilt 92, cb 92, Center. 
Farill, John Paul, mc Atlanta 81, cb 87, Farill. 
Ison, Hartford Lee, mc Atlanta Southern 91, cb Tallapoosa 91, Center. 
McWhorter, Robert Lee, mc Alabama 87, cb 87, Oaylesyille. 
Miller, Thomas Gideon, mc Kentucky s of m 86, cb 86, Oaylesyille. 
Shamblin, Arthur C, mc Chattanooga 92, cb 94, Oaylesyille. 
Tatum, Samuel Carter, mc uniy Vanderbilt 93, cb 93, Center. 
Total, 7. 

Honorary Memhera. 

Farill, John Washington, ng old law, cb 87, Farill. 
Jones, Henry S., mc Atlanta, cb 99, Moshat 
Shamblin, Arnold, ng, old law, cb 87, Broomtown. 

PHYSICIANS NOT MEItfBlEBB OF THB BOOmT. 

Ballard, Ira Chelsea, mc Chattanooga 1900, cb 1900, Leesburg. 
Bomar, Richard Rltter, mc Atlanta Southern 85, cb 85, Bomar. 

Brown, A. M., mc , cb 87, Round Mountain. 

Cook, Edward Augustus, mc uniy Vanderbilt 84, cb 84, Kirks Oroye. 
Crumpton, Wesley Hollingsworth, mc Chattanooga — , cb Cleburne 

97, Alexis. 
Elliott, Theoderic Miles, mc Kentucky s of m 76, cb 87, Grassland. 
Emerson, JefFerson Forrest, mc Chattanooga 95, cb Marshall 68, 

Rock Riyer. 
Matthews, John Patrick, mc uniy NashyiUe 86, cb 87, Maple Oroye. 
McElrath, William S., mc Memphis Hospital 1900, cb 1900, Cedar 

Bluff. 
Morgan, W. T., mc uniy Vanderbilt 92. cb Calhoun 96, Rock Run. 
Shamblin, John Louis, mc Atlanta 88, cb 88, Broomtown. 
Sharp, Oeorge Barnabas, mc Atlanta Southern 93, cb 93, Forney. 

Slack, John C, mc , cb 87, Slackland. 

Stubbs, William Lee, mc Alabama 99, cb 99, Cedar Bluff. 

White, Thomas Noel, mc uniy of Oeorgia 57, cb 87, Spring Oarden. 

Wills, , illegal. Wills. 

Wright, Luther, mc Atlanta Southern 98, cb 98, Forney. 

Total, 17. 



THE MtOLL OF TBE COTXTT 80CIKTIE8. 161 



Moved Into tht eovnty— Iim C BiDud. tnm ChattttnooiB* 
to LMMbiirg; Dr. Greeo. troai Tens, to Forney. 

Moved out o( tke coontjr— Robert H. McGbee, from RcMUd Moiitt- 
tmin to iTiTiii^w TuecalooeA comity; William T. White, tnm Striae 
Gerdcn to Piedmont CiUioim county : Jnlins & MitcheU* from Fol- 
leiton to pnrtB unknown. 

Rramlnetlons— Ira a Ballard, mc AtlanU Soathem 1900. eerti* 
llcate granted: William 8. McElrath, Mempliia IL M C^ 1900. certl* 



Deatli— C. Story, drowned. Key. 

•CHILTON COUNTY MEDICAL SOCIETY— SeUna, 1879. 



President, W. E. Stewart; Vice-President, B. A. Matthews; See* 

retary. ; Treasnrer. ; Health Officer. ^. 

Censors— W. E. Stewart. E. A. Matthews. 

NAios or wpM—iMf wrrH thkib oollbos ahd Posr-omcBS. 



Cafley. Hugh William, mc South Carolina 55, cb Lowndes 83. Ver- 
bena. 

Clanghton. Alia B.. mc Atlanta — , cb — , Maplesville. 

Matthews. EmmeU Abram, mc Alabama 87. state board 86. Clanton, 

McNeil, R. Bemey, mc Birmingham 98. cb 98, Jemison. 

Pamell. Charles Nickols, mc Alabama 91. cb 91, Stanton. 

Stewart. William Eugene, mc Louisrille 75, cb 79, Clanton. 

Wise. William Tell, mc Atlanta 89. cb 94. Coopers. 
Total. 7. 

PHT8ICIA1T8 NOT MaMBBBH OF TKX SOCXCTT. 

Dawson, James Jefferson (old law), cb Autauga 56. Verbena. 
Hayes, Julius Poe, mc 96, cb 96. Clanton. 
Pitts, John Spate, mc Nashville 68, cb 79, Verbena. 
Wise. John P., mc Graffenburg 56, cb 79, Coopers. 
Total, 4. 

*NoTB— As no report has been received from Chilton county this 
year, the report of 1900 is here reproduced. 

11 



132 ^^^ MEDICAL ASSOCIATION OF ALABAMA. 

CHOCTAW COUNTY MBDICAL SOCIETY— Selma, 1879. 

OmOBBS. 

President, J. C. Christopher; Vice-President* Samuel Almaa; 
Secretary, J. L. Granberry; Treasurer, J. L. Oranberry; Health 
Officer, J. L. Granberry. Censors— R, P. Moody, F. B. Christo- 
pher, D. T. McCall. 

NAMES OF MEMBERS WITH THKIB OOLLBGES AND POST-OSTIGBS. 

Alman, Samuel mc Louisville 99, cb 99, Melvin. 
Christopher, John C, mc LouisyiUe 94, cb 94, DeSotoville. 
Christopher, Frank Erans, mc Louisville 94, cb 94, Isney. 
Granberry, Joseph Langley, mc LouiSTllle 91, cb 91, Pushmataha. 
Johnson, Samuel F., ng, Butler. 

Lenoir, Thomas R., mc Alabama 92, cb 92, Womack Hill. 
McCall, Daniel T., mc LouisyiUe 94, cb 94, Butler. 
Moody, Robert Franklin, mc univ Louisiana 60, cb 79, Butler. 
Needham, Eli Wigginton, mc univ Louisiana 68, cb 79, Lusk« 
Phillips, Jacob Parker, mc Alabama 86, cb 85, Yantley. 
Young, Robert Lee, mc Alabama 86, cb 88, Mt. Sterling. 
Total, 11. 

PHYSICIANS NOT MEMBERS OF THE BOdETT. 

Brown, Collins Balsam, mc , cb — , Cocoa. 

Turner, Matthews, mc , cb — , Bladon Springs. 

Deaths— F. P. Clarke, Sept. 1900; W. F. Klmbrough. 



CLARKE COUNTY MEDICAL SOCIETY— Greenville, 1885. 

OfTICERS. 

President, J. W. Fleming; Vice-President, J. W. Armistead; Sec- 
tary, C. E. Pugh; Treasurer, J. M. Cobb; Health Officer, G. S» 
Chapman. Censors — J. T. Pugh, J. B. Evans, B. S. Barnes, J. W. 
Armistead, C. E. Pugh. 

NAMES OF MEMBERS WITH THEIR COLLEGES AND POST-OFFICES. 

Armistead, James Westwood, mc Alabama 83, cb 84, Grove Hill. 
Barnes, Benjamin Shields, mc univ Pennsylvania 59, cb 84, Suggs* 

vlUe. 
Boroughs, Bryan, mc univ Louisville 70, cb 84, Jackson. 
Chapman, Gross Scruggs, mc Alabama 79, cb 83, Jackson. 
Cobb, Jesse Monroe, mc univ Tulane 84, cb 94, Grove Hill. 
Davidson James S., mc Alabama 89, cb 89, ThomasviUe. 
Davis, Henry George, mc Alabama 72, cb 84, Gainestown. 
Evans, Joe E., mc Alabama 99, cb 99, ThomasviUe. 
Fleming, John William, mc Alabama 79, cb 84, Salitpa. 



THE ROLL OF TSB COUNTY B00IBTIB8. Igft 

Gilmore, John Arcade, mc only Louisville 86, eb 86, ThemasTille.. 
Hicks, Lamartine Orlando, mc Alabama 73, eb 84, Jackaon. 
Jeffrey, James Grey, mc Alabama 88, cb 88, Wbatley. 
Klmbrough, William Augustus, mc Alabama 86, cb 96, CUendon> 
Kimbrough. John, mc Alabama 98, cb 98, Thomasville. 

Kirvin, Thomas J., mc , cb — , Jackson. 

Nidiols, Cobb, mc Alabama 98, cb 1901, Jacksom 
Pusb, Clonent Eugene, mc Alabama 89, cb 89, Orove Hill. 
'Pugh^ Albert Sidney, mc s of m Kentucky 92, cb 93, Orove Hill. 
Pusli. John Talbert, mc Alabama 97, cb 97, Jackson. 
Wblte, Alexander L., mc Alabama 98, cb 98, CobbviUe. 
Total, 20. 

PHTBICIANS NOT MEMBKB8 OF THE 80CIETT. 

Armistead, Lee, ng, Campbell. 

Barefield, Henry Litman, mc Alabama 72, cb Cherokee 87, Gosport. 
Dalilberg, Charles Isaac, mc Alabama 87, eb Choctaw 88, Suggsvilla. 
Prim, Thomas Jefferson, ng, Salitpa. 
Total, 4. 

Retired — ^James Threadgill, Thomasville. 

lAoyed into the county — Cobb Nichols, from Tampico, Mexico, to 
Jackson; T. J. Kirvin, from Texas to Jackson. 

Bxaminations — Cobb Nichols, certificate granted. 

CLAY COUNTY MEDICAL SOCIBTY— Tuscaloosa. 1887. 

OFFICEBS. 

President, Thomas Northen; Vice-President, C. W. Darby; Secre^ 
tary, C. P. Oay; Treasurer, 8. J. Gay; Health Officer, Thomas 
Northen. Censors — S. J. Gay, C. S. Northen, A. R. Stephens, S. J. 
Gay, J. H. Garrett, B. A. Stephens. 

NAMES OF MBMBIEBS WITH THKIB OOLLBQES AST) P08TOFFIGES. 

Black, Orlando B., mc uniy of South 1901, cb 1901, Rozell. 
Darby, Cunningham Wilson, uniy Georgia — , cb 87, Rozell. 
Garrett, John Henry, mc Atlanta Southern 92, cb 92, Delta. 
Gay, Coleman Pendleton, mc Atlanta Southern 97, cb Randolph 97, 

Lineville. 
Gay, Stonewall Jackson, mc Atlanta Southern 88, cb 88, Lineville. 
Irvin, William Fletcher, mc uniy Louisyflle 87, cb 87, Millenrille. 
Jordan, Joseph Wiley, mc Atlanta 91, eb 87, Ashland. 
Manning, John Thomas, mc uniy Vanderbilt 85, cb 87, Wesobulga» 
McDairmid, Angus Kelley, mc Alabama 72, cb 87, Hollins. 
Northen, Thomas, mc Atlanta 78, cb 87, Ashland. 
Northen, Charles Stephens, mc Atlanta 91, cb 89, Ashland. 



164 THE MEDICAL ASSOCIATION OF ALABAMA. 

Owens, Seaborn Wesley, unlv Oeorgia — , cb 87, Bluff Springs. 
Sims, George Nelson, mc Graflenburg 56, cb 87, Ashland. 
Stephens, Albert Russell, mc Atlanta Southern 88, cb 88, Delta. 
Stephens, Burrell Anderson, mc Alabama 92, cb 92, LineylUe. 
Total, 15. 

PHYSICIANS NOT MEMBERS OF THE SOCIETY. 

McDaniel, J. C, uniy Georgia — , cb 87. 
Harris, D. C, unlv Georgia — , cb 87. 

Moved out of the county — James Clin Griffin, from to . 

Examinations — James Olln Griffin, mc Alabama, 1900 certificate 
granted; Orlando B. Black, unic South (Sewanee, Tenn.) 1901, 
certificate granted. 

CLEBURNE COUNTY MEDICAL SOCIETY— Selma, 1884. 

OFFICEBS. 

President, S. L. B. Black; Vice-President, J. M. Lindsey; Secre- 
tary, T. J. Johns; Treasurer, T. J. Johns; Health Officer, S. L. Wil- 
liams. Censors — ^T. J. Johns, J. D. Creamer, J. W. Kaylor, W. H. 
Lindsey, Jas. H. Ligon. 

NAMES OF MEMBEB8 WITH THUB OOLLBOES AND FOST-OITIOEa. 

Black, Simeon Lovell Bearee, mc Ohio 69, cb 98, Fruithurst. 
Creamer, James David, mc Atlanta Southern 93, cb 93, Abemathy. 
Johns, Thomas Jefferson, mc Alabama 88, cb 93, EdwardsviUe. 
Kaylor, James William, mc Atlanta Southern 97, cb 97, Arbaooochee. 
Ligon, James H., univ Vanderbilt 91, cb 91, Oakfuskee. 
Ligon, Wilson Milton, mc Georgia — , cb 84, Oakfuskee. 
Lindsey, Jeremiah M., mc Chattanooga 97, cb 97, Fruithurst 
Lindsey, William Henry, mc Chattanooga 94, cb 94, Fruithurst 
Pennington, James Edward, mc Georgia 88, cb 94, Easom Hill, Ga. 
Reid, Rhesa Thomas, ng — , cb 84, EdwardsviUe. 
Robert, David P., ng — , cb 84, Oak Level. 
Simpson, J. L., mc Atlanta 80, cb Coosa 83, Heflin. 
Williams, Sidney Lorenza, mc Chattanooga 94, cb 94, Hightower. 
Wright, Lee Roy, mc univ Vanderbilt 1900, cb 1900, Heflin. 
Total, 14. 

PHT8I0IANS NOT MEMBERS OF THE SOOIETT. 

Haygood, S. P., cb 84, Soloman. 

Hudgens, Noel C, mc Georgia 47, cb 84, Oak Level 

Putt. W. T., irregular, Fruithurst 

Sorrell, John Wesley, mc — , cb 84, Chulaflnnee. 

Total, 4. ; 



THE ROLL OF THE COUNTY B00IETIE8. IQS^ 

Marked out of the county — T. L. Thomaaon, from Heflin to Atlanta^ 
Oa. ; Thomas T. Wheeler, to Steels Depot, St Clair county. 

Elxamlnatlona — Thomas Tyler Wheeler, mc Chattanooga 1900, cer* 
tillcate granted; William Henry Greer, mc Chattanooga 1900, cer^ 
tific&te granted; Lee Roy Wright, mc univ Vanderbilt 1900, certill- 
cate granted. 

COFFEE COUNTY MEDICAL SOCIETY— Greenville, 1885. 

0fnCKB8. 

President, H. R. Bradley; Vice-President, P. T. Fleming; Secre- 
tary, J. P. Phillips; Treasurer, H. F. A. Harp; Health Of&cer, H. 
P. A. Harp. Censors— P. T. Fleming, H. R. Bradley, H. F. A. 
Harp, B. R. Ballard, W. A. Lewis. 

NAMES OF MEMBEBS WFTH THEIB 0OLLB0E8 Ain> FOSIVOITICBS. 

Ballard, Benj. Randal, mc univ Tennessee 94, cb Crenshaw 94, Al- 
berton. 

Blue, Jasper Dixon, ng. 86, Elba. 

Bradley, Henry Rudolph, mc Alabama 96, cb Barbour 96, Elba. 

Colley, Aaron Thomas, mc univ Louisville 94, cb Pike 94, Enterpriseii. 

Orubbs, Wm. Westford, mc univ Louisville 89, cb Covington 90, En* 
terprise. 

Fleming, Porter Thomas, mc univ Louisville 94, cb 94, Enterprise. 

Harp, Hector Frederick Augustus, mc Alabama 93, cb 93, Elba. 

Hilliard, Chas. Wesley, mc Alabama 95, cb Pike 95, Elba. 

Lewis, Walter Augustus, mc univ Tulane 97, cb Barbour 97, Enter- 
prise. 

Phillips, Jas. P., mc Memphis 98, cb Dale 98, Brockton. 
Total, 10. 

PHYSICIANS NOT MEMBERS OF THE SOCIETY. 

Andrews, , Enterprise . 

Crook, Wm. Henry, mc Alabama 84, cb 85, Victoria. 
Dalton, T. E., mc Georgia Eclectic 94, cb 96, Curtis. 
Hill, BenJ. Augustus, mc Richmond 60, cb 95, Elba. 
Howell, David D., mc — , cb — , Brockton. 
Mathews, Wm. Forth, mc Atlanta 95, cb 97, Eta. 
Lewis, Benj. J., mc Alabama 99, cb 99, Fresco. 
Rushing, Francis Marion, mc univ Louisiana 51 ,cb 85, Elba. 
Total, 8. 

Moved into the county— C. W. Hilliard, from Troy, Pike county^ 
to Elba. 

Moved out of the county — N. M. Ham, from Elba to Bullock, Cren- 
shaw county. 



|gg THE MEDICAL ASSOCIATION OF ALABAMA. \ 

GOLBERT COUNTT MEDICAL 80CIETT— Montgomery. 1881. 

OFFICEBS. 

Prealdent, W. A. Bums; Vice-President, J. B. Wiley; Secretary, 
H. B. Thompson; Treasurer, H. B. Thompson; Health Officer, H. 
B. Thompson. Censors — C. R. Palmer, H. W. Blair, W. A. Bums, 
G. T. McWhorter, H. B. Thompson. 

NAMES OF MEMBEBB WITH THEIB COLLEGES AND POST-OFFICES. 

Bums, Wm. Arthur, mc Memphis 91, cb Lamar 91, Sheffield. 
Blair, Hugh Walter, mc univ Vanderbilt 88, cb 88, Sheffield. 
CJoms, Christian Z., mc univ Vanderbilt 99, cb Winston 99, Sheffield. 
<yOoper, Samuel J., mc Memphis Hospital 71, cb — , Tuscumbia. 
McWhorter, Geo. Tilghman, mc uniy Louisville — , cb 81, Riverton. 
"Moore, Riley Jackson, mc univ Louisville — , cb 81, Riverton. 
Palmer, Charles Richard, mc univ Vanderbilt 83, cb 83, Tuscumbia. 
Rand, Edward P., mc univ Tulane 72, cb 81, Tuscumbia. 
Robinson, John Abner Pruitt, mc univ St. Louis 72, cb 78, Leighton. 
Thompson, Humphrey Bate, mc Louisville 93, cb 93, Tuscumbia. 
Walker, David Harris, mc univ Vanderbilt 81, cb 82, Spring Valley. 
Wiley, James E., mc Alabama 96, cb 96, Tuscumbia. 
TWall, Alfred Alexander (retired), mc Pennsylvania 49, cb Madison 

78, Tuscumbia. 

ToUl, 13. 

PHYSICIANS NOT MEMBERS OF THE SOCIETY. 

darter, Patrick Parkerson, mc univ Louisville, 66, cb 79, Brick. 

Diebold, , mc Tulane , Sheffield. 

Oilmore, Francis T. mc Louisville (retired), Tuscumbia. 

King, Frederick Q. . 

"Masterson, Allent Aaron, mc univ Louisville 89, cb Lawrence 89, 
Leighton. 

'Masterson, John H., mc univ Louisville 89, cb 89, Cherokee. 

McCluskey, James A., ng. Rock Creek. 

Morris, Charles Thomas, mc univ Louisville 75, cb Henry 78, Shef- 
field. 

O'Reilley, John Edmund, mc Alabama 74, cb 84, Cherokee. 

Smith, James Clark, mc Vanderbilt 85, cb Elmore 85, Tuscumbia. 

Williams, Charles W., mc Nashville Med. College 81, cb 81, Cherokee. 
Total, 11. 

Moved into the county — Samuel J. Cooper, from Memphis, Tenn., 
to Tuscumbia; Wyatt Heflln Blake, from Wetumpka, Elmore coun- 

ty, to Sheffield; Henry, from to Leighton; C. M. Dil- 

lard, from New Orleans, to Sheffield. 

Moved out of the county — Benj. Johnson, from Leighton, to . 



THE BOLL or THE COUVTY BOOUTlSa. 167 

GONBCUH COUNTY MEDICAL 80CIBTY— Selma, 1879. 

OFTICEBS. 

President, W. F. Betts; Vice-President, J. N. Mlxon; Secretary* 
Andrew Jay; Treasurer, Andrew Jay; Health Officer, P. M. Bruner. 
Ceneora. — ^W. F. Betts, E. L. Stallworth, P. M. Bruner, Andrew Jay, 
R. T. Holland. 

ITAMS8 or MEMREBS WFTH THEIB COLLB0K8 AirD POST-OmCKS. 

Belts, William Frank, mc Tulane 93, cb 95, Evergreen. 

Bradley, Ely, mc unlv Pennsylyanla 59, cb 84, Bellvllle. 

Bruner, Plnckney McDonald, mc Alabama 61, cb Lowndes 79, Ever- 
green. 

Fountain, Hugh Thomas, mc Alabama 72, cb Monroe 79, Burnt Com. 

Holland, Richard Thomas, mc Alabama 90, cb Escambia 90, Castle- 
berry. 

Jay, Andrew, mc Alabama 72, cb 84, Evergreen. 

Mixon, John Nelson, unlv Louisville 98, cb 98, Commerce. 

McCreary, John Absalom, mc unlv Louisiana 60, cb 84, Evergreen. 

McKittrlck, Adam Alexander, mc Georgia 60, cb 84, Evergreen. 

Ruback, Carl, mc Memphis 96, cb 96, Evergreen. 

Shaver, William Benjamin, unlv Georgia Reform 60, cb 84, Herberu 

Stallworth, Emmet Lemuel, mc Alabama 94, cb 94, Evergreen. 

Taliaferro, Charles Thomas, mc Atlanta 59, cb 84, Evergreen. 

Tatum, Fletcher Lothair, mc Atlanta 95, cb Pike 95, Brooklyn. 

Watson, William, mc Alabama 93, cb 98, Repton. 
Total, 15. 

Honorary Member, 

Belo, Frederick Arthur, mc Jefferson 74, cb — , Evergreen. 

COOSA COUNTY MEDICAL SOCIETY— Birmingham, 1883. 

OmCKBS. 

Presldent,A. J. Peterson; Vice-President, J. C. Cousins; Secretary, 
Julius Jones; Treasurer, E. Argo; Health Officer, J. W. Pruett Cen- 
aors — J. Jones, A. J. Peterson. E. Argo, J. C. Cousins, W. A. Hoi* 
loway. 

NAMES or MEMBERS WITH THEIB COLLEGES AND POST-OFFICES. 

Argo, Eugene, mc unlv Vanderbilt 91, cb 91, Goodwater. 
Cousins, James Columbus, mc unlv Maryland 91, cb 91, Equality. 
Dunlap, William B., ng, cb 85, Holllns. 

Grimes, John W., mc univ of South 99, cb 99, Marble Valley. 
Holloway, William A., mc Alabama 89, cb Tallapoosa 89, KellesrtoiL 



Igg THE MEDICAL ASSOCIATION OF ALABAMA. 

Jones, Julius, mc univ Vanderbllt 84, cb 84, Rockford. 
McKinney, Eugene P., mc univ Louisville, 93, cb 93, Kelleyton. 
Moon, William Henry, mc Alabama 79. cb 83, Goodwater. 
Nolen, Richard Spencer, mc Kentucky s of m 89, cb 89, B«quality. 
Peterson, Albert James, mc univ Vanderbllt 89 ,cb 89, Hanover. 
Pruett, James W., mc Alabama 92, cb Talladega 92, Weogufka. 
Total, 11. 

PHYSICIANS NOT MEMBERS OF THE 80CIETT. 

Dollar. Henry Clay, mc Atlanta 75, cb 83, Marble Valley. 
Hadoz, Wm., mc univ Tennessee 91, cb Elmore 91, Travelers Rest. 
Mathews, John Thomas, mc univ Tulane 73, cb 84, Hanover. 
Maxwell, Cecil Kelley, mc Alabama 92, cb 92, Kellyton. 
Salter, Paschal Preston (botanist), ng, cb 84, Gk>od water. 
White, William Tanner, mc Tennessee 86, cb 86, Rockford. 
Total, 6. 

Moved out of the county — Jas. M. Smith, from Nixburg to Sylla- 
cauga, Talladega county. 

Examinations — J. C. McLeod, mc Birmingham, certificate granted; 
J. M. Smith, mc Alabama, certificate granted. 

Deaths — W. J. Peddy, valvular heart disease, October, 1900» 
age 69, Rockford. 

•COVINGTON COUNTY MEDICAL SOCIETY— Montgomery, 1888. 

OFFICERS. 

President, W. E. Sentell; Vice-President, J. R. Ealum; Secretary, 
; Treasurer, J. R. Ealum; Health Officer, . 



Censors — W. E. Sentell, J. R. Ealum, T. C. Bozeman, W. T. Stenson^ 

NAMES OF MEMBERS WITH THEIR COLLBOES AND POST-OFFICES. 

Bozeman, T. Compton, mc Alabama 92, cb 93, Searight 
Ealum, James R., mc Alabama 91, cb 91, Oakey Streak. 
Sentell, Wilbur Eugene, mc Alabama 89, cb 91, Andalusia. 
Stenson, William T., mc Atlanta 91, cb 91, Rose Hill. 

Street, William N., mc , cb — , Hilton. 

Total, 5. 

PHYSICIANS NOT MEMBERS OF THE SOCIETY. 

Atkinson, Alexander O., ng. Red Level. 

Raggett, , mc , cb — , Eclectic. 

Brown, T. J., (illegal). Rat. 

Cawthom, Samuel J. S., ng, cb 90, Andalusia. 

Patrick Thomas, ng, Green Bay. 



THE ROLL OF THE COUNTY SOCIBTJEB. 16ft 

Miller, , (illegal), Florella. 

Pienon, W. W., (Illegal), Red Level. 
Roberts, James M., ng, Beda. 
Sellers, Thomas L., ng, Andalusia. 
Whaley, James A., ng, Oreen Bay. 
Total, 10. 

*NoTE— As no report has been received from Covington county this 
year, the report of 1900 is here reproduced. 

CRENSHAW COUNTY MEDICAL SOCIETY— Mobile, 1882. 

omcERs. 

President, J. R. Horn; Vice-President, F. M. T. Tankersley; Se<y 
retary, C. R. Rushton; Treasurer, C. R. Rushton; Health Offlcer, 
Q. S. Tankersley. Censors — J. R. Horn, F. M. T. Tankersley, 0. 
R. Rushton, S. W. May, A. J. Jones. 

2VAME8 OF MEUBBBS WITH THEIB COLLEOES AND POSTOFFICES. 

Avant. William Watts, mc univ Tennessee 90, cb — , Patsburg. 

Bnrgamy, William Thomas, mc Jefferson 69, cb 88, Rutledge. 

Coston, William Henry, mc Atlanta Southern 89, cb 88, Brantley. 

Elland. Thomas C, 98, cb 98, Bullock. 

Ham, Nelson Matthews, mc Alabama 98, cb Coffee 98, Bullock. 

Horn, Richard Kersey, mc Georgia Eclectic 81, cb 84, Bullock. 

Horn, Joseph Robert, mc Alabama 87, cb 87, Luveme. 

Jones, Andrew Jackson mc Louisville 85, cb 85, Highland Home. 

Kendrick, James E^7ans, mc Alabama 69, cb 82, Luveme. 

Knight, William Peter, mc A/tlanta Southern 92, cb Butler 92, Lu- 
veme. 

May, Samuel William, mc phys and surg Baltimore 82, cb 83, Brantr 
ley. 

Moxley, Jos. Benjamin, mc Georgia Eclectic 99, cb 99, Brantley. 

Odom, William F., mc univ Tennessee 94, cb Covington 94, Searight 

Richardson, Roddie, mc univ Tennessee 98, cb 98, Salsoda. 

Rushton, Christopher Reid, mc Atlanta Southem 92, cb Covingtoik 
92, Rutledge. 

Sheppard, Charles Webb, mc Atlanta Southem 91, cb Butler 91». 
Honoraville. 

Thankersley, Felix Marcus Tullius, univ Tennessee 85, and Tulane 95». 
cb 85, Highland Home. 

Tankersley, George Stewart, mc Tulane 93, cb 93, LaPine. 

Thrower, Steven Simon, ng, cb 84, Bradlesrton. 
Total, 19. 

Honorary Member. 

Williamson, Geo. Washington, mc Alabama 93, cb 93, Goshen. 



170 ^^^ MEDICAL ASBOOIATION OF ALABAMA. 

PHYSICIANS NOT MEMBCB8 OF THE 80CIETT. 

Dennis, S. H., mc univ Graffenberg 58, cb Pike 78, Petrey. 
Dyer, Edward Fox, nx, cb 84, Rutledge. 

Pord, Julian C, mc , cb Pike — , Bradleyton. 

Pryor, William Dayton, mc univ Tennessee 67, cb Butler 81, Aiken. 
Hay, Thomas Quincy, mc Atlanta Southern 94, cb 94, Searight 
Total, 5. 

Moved into the county — S. H. Dennis, from Oulustie Greek, Pike 
county to Petrey; N. M. Ham, from Blba, Coffee county, to Bullock. 

Moved out of the county — L. E. Broughton, from Searight to An- 
dalusia, Covington county; T. J. Stough, from Petrey to Mont- 
gomery. 

Deaths — D. N. Moxley, Olenwood. 
CULLMAN COUNTY MEDICAL SOCIETY— Anniston, 1886. 

OFFICEBS. 

President, G. Hartung; Vice-President, W. W. Whorton; Secretary, 
M. L. Johnson; Treasurer, G. Hartung; Health Officer, John Yield- 
ing. Censors— G. Hartung, G. W. Watts, R. H. Baird, John Yield- 
ing, M. L. Johnson. 

NAMES OF MEMBEBS WITH THEIR COLLEGES AND POST-OFTICES. 

Baird, Robert Henry mc Alabama 92, cb Blount 92, Cullman. 

Brindley, Bethea Pace, mc Atlanta Southern 92, cb 92, Slmcoe. 

-Cossey, Thomas Watson, mc Atlanta Southern 91, cb 96, Jones 
Chappel. 

Harris, George Riley, ng, cb 92, Garrison Point. 

Hartung, Gottloeb, mc Wuerzburg, Germany 78, cb 92, Cullman. 

Humphries, Roman Willis, mc Atlanta Southern 92, cb 96, Logan. 

Johnson, Marquis LaFayette, mc Alabama 75, cb Marshall 86, Cull- 
man. 

Martin, William Henry, mc univ Tennessee 88, cb 89, HancevlUe. 

Moon, James Prince, mc univ Grant 1900, cb 1901, Bremen. 

Price, William Henry, mc univ Tennessee 90, cb Cleburne 98, Crane 
Hill. 

Walling, John Henry, ng, cb 89, Vinemont. 

Watts, George Wesley, mc Atlanta Southern 88, cb 89, Holly Pond. 

Whorton, William Walton, mc univ Vanderbilt 90, cb Marshall 90, 
Cullman. 

Yielding, John, mc univ Grant 94, cb Cullman 94, Walter. 
Total, 14. 



TBM BOLL OF TEB COUVTY 800IETIB8. m 

nnrsiciAHS kot mbmbuis op tbk aocnrr. 

Burnom, Francis Marion, mc untv Nashville 79. cb 86. Cullman. 
Cmiiibley, Jessie James, mc Atlanta 92, cb 94, Holly Pond. 
Haden. Henry Hughes, mc nnlT Vanderbllt 86, cb Blount 86, Holly 

Pond. 

Hudson, William Henry, mc , cb Blount 86, Walter. 

Herrin, Edward CalYin, ng, (illegal), Trimble. 

JohiKSton, Pinckney Thomas, mc Louisville 83, cb Marion 85. Bremen. 

Keller, Louis Martin, mc Atlanta 88, cb 88, Btha. 

McLstrty, George Washington, mc Nashyille 76. cb 86. Joppa. 

Mamsum, William Landrum, mc Georgia 59. cb 86, Cullman, (retired). 

MoBsrOYe, Phillip Mason, mc Memphis 60, cb 84. Cullman, (retired). 

Oden., James Henry, mc Old Law, cb 88, Unity. 

^Wtmi, James Thomas, mc univ Vanderbilt 89, cb 89. Baileyton. 

Total. 12. 

Moved into the county — Crumbley, Jessie James, from Draketown* 
Ga.. to Holly Pond; Haden, Henry Hughes, from Summit, Blount 
county, to Holly Pond. 

Moved out of the county, John Smith Ainsley, from Trimble to 
Lo'wndesboro; James Niles Buchannon. from Cullman to Adger, 
Jefferson county; Luther Hays, from Cullman to North Birming* 
bam; Hamilton Hany Kimey, from Bremen to Norih Birmingham. 

Szaminations — ^James Price Moon, mc Grant University, certificate 
granted; Luther Hays, mc univ Grant 1900, certificate granted. 

Death— William Alexander McDonald, Baileyton, 

DALE COUNTY MEDICAL SOCIETY— Tuscaloosa, 1887. 

OFTICEBS. 

President — S. M. C. Howell; Vice-President, B. F. Coleman; Sec- 
retary, R. F. Harper; Treasurer, R. F. Harper; Health Officer, B. 
B. Ard. Censors— E. B. Ard, R. F. Harper, F. B. Cullens, B. L. 
Byrd, J. C. Oates. 

KAMES OF MEMBZRS WITH THEIR COLLEGES AND POST-OFFICES. 

Ard, Erastus Byron, mc uniy Vanderbilt, 87, cb 87, Ozark. 
Barnes, Charles Duncan, mc Alabama 97, cb 97, Osark. 
Byrd, Benjamin Littleberry, mc Alabama 92, cb 92, Dalevllle. 
Coleman, Benjamin Franklin, mc uniy Nashyille 61, cb Bullock 76» 

Osark. 
Cullens, Frederick Bacon, ng, State Board 97, Ozark. 
Harper, Robert Franklin, mc Alabama 88, cb Coffee 88, Osark. 
Holman, Henderson Loony, mc Memphis 98, cb Marion 98, Osark. 



3^70 ^^^ MEDICAL ASSOCIATION OF ALABAMA. 

PHYSICIANS NOT MBMBEB8 OF THE SOCIETT. 

Dennis, S. H., mc univ Graflenberg 58, cb Pike 78, Petrey. 
Dyer, Edward Fox, nz, cb 84, Rutledge. 

Pord, Jalian C, mc , cb Pike — , Bradleyton. 

Pryor, William Dayton, mc univ Tennessee 57, cb Butler 81, Aiken. 
Hay, Thomas Quincy, mc Atlanta Southern 94, cb 94, Searight 
Total, 5. 

Moved into the county — S. H. Dennis, from Oulustie Creek, Pike 
county to Petrey; N. M. Ham, from Elba, Ck>free county, to Bullock. 

Moved out of the county — L. E. Broughton, from Searight to An- 
dalusia, Covington county; T. J. Stough, from Petrey to Mont- 
gomery. 

Deaths — D. N. Moxley, Olenwood. 
CULLMAN COUNTY MEDICAL SOCIETY— Annlston, 1886. 

OFFICERS. 

President, G. Hartung; Vice-President, W. W. Whorton; Secretary, 
M. L. Johnson; Treasurer, 6. Hartung; Health Officer, John Yield- 
ing. Censors — G. Hartung, G. W. Watts, R. H. Baird, John Yield- 
ing, M. L. Johnson. 

NAMES OF MEMBEBS WITH THEIB COLLEGES AND POST-OFFIGES. 

Baird, Robert Henry mc Alabama 92, cb Blount 92, Cullman. 

Brindley, Bethea Pace, mc Atlanta Southern 92, cb 92, Simcoe. 

-Oossey, Thomas Watson, mc Atlanta Southern 91, cb 96, Jones 
Chappel. 

Harris, George Riley, ng, cb 92, Garrison Point. 

Hartung, Gottloeb, mc Wuerzburg, Germany 78, cb 92, Cullman. 

Humphries, Roman Willis, mc Atlanta Southern 92, cb 96, Logan. 

Johnson, Marquis LaFayette, mc Alabama 75, cb Marshall 86, Cull- 
man. 

Martin, William Henry, mc univ Tennessee 88, cb 89, Hanceville. 

Moon, James Prince, mc univ Grant 1900, cb 1901, Bremen. 

Price, William Henry, mc uniy Tennessee 90, cb Cleburne 98, Crane 
Hill. 

Walling, John Henry, ng, cb 89, Vinemont. 

Watts, George Wesley, mc Atlanta Southern 88, cb 89, Holly Pond. 

Whorton, William Walton, mc univ Vanderbilt 90, cb Marshall 90, 
Cullman. 

Yielding, John, mc univ Grant 94, cb Cullman 94, Walter. 
Total, 14. 



THE ROLL OF THE COUNTY BOOIETIEB. 171 

PHYSICIANS KOI MBMBEB8 OF THR 800IETT. 

Bumum, Francis Marion, mc univ Nashville 79, cb 86, Cullman. 

Crumbley, Jessie James, mc Atlanta 92, cb 94, Holly Pond. 

Haden, Henry Hughes, mc univ Vanderbilt 86, cb Blount 86, Holly 

Pond. 

Hudson, William Henry, mc •. , cb Blount 86, Walter. 

Herrin, Edward Calvin, ng, (illegal), Trimble. 

Johnston, Pinckney Thomas, mc Louisville 88, cb Marion 86. Bremen. 

Keller, Louis Martin, mc Atlanta 88, cb 88, Btha. 

McLarty, George Washington, mc Nashville 76, cb 86, Joppa. 

Mangum, William Landrum, mc Georgia 59, cb 86, Cullman, (retired). 

Musgrove, Phillip Mason, mc Memphis 60, cb 84, Cullman, (retired). 

Oden, James Henry, mc Old Law, cb 88, Unity. 

Winn, James Thomas, mc univ Vanderbilt 89, cb 89, Baileyton. 

Total. 12. 

Moved into the county — Crumbley, Jessie James, from Draketown» 
Cki., to Holly Pond; Haden, Henry Hughes, from Summit, Blount 
county, to Holly Pond. 

Moved out of the county, John Smith Ainsley, from Trimble to 
Lowndesboro; James Niles Buchannon, from Cullman to Adger, 
JefEerson county; Luther Hays, from Cullman to North Birming- 
ham; Hamilton Hany Kimey, from Bremen to North Birmingham. 

Examinations — James Price Moon, mc Grant University, certificate 
granted; Luther Hays, mc univ Grant 1900, certificate granted. 

Death — ^William Alexander McDonald, Baileyton. 

DALE COUNTY MEDICAL SOCIETY— Tuscaloosa, 1887. 

OFFICEBS. 

President — S. M. C. Howell; Vice-President, B. F. Coleman; Seo- 
retary, R. F. Harper; Treasurer, R. F. Harper; Health Officer, B. 
B. Ard. Censors — E. B. Ard, R. F. Harper, F. B. CuUens, B. L. 
Byrd, J. C. Gates. 

NAMES OF MEMBERS WITH THEIB COLLEGES AND POST-OFFIOES. 

Ard, Erastus Byron, mc univ Vanderbilt, 87, cb 87, Ozark. 
Barnes, Charles Duncan, mc Alabama 97, cb 97, Ozark. 
Byrd, Benjamin Littleberry, mc Alabama 92, cb 92, Dalevllle. 
Coleman, Benjamin Franklin, mc univ Nashville 61, cb Bullock 75* 

Ozark. 
Cullens, Frederick Bacon, ng. State Board 97, Ozark. 
Harper, Robert Franklin, mc Alabama 88, cb Coffee 88, Ozark. 
Holman, Henderson Loony, mc Memphis 98, cb Marion 98, Ozark. 



172 ^^^ MEDICAL ASSOCIATION OF ALABAMA, 

Howell, Samuel Matthew Crawford, mc Atlanta 91, cb 91, Midland 

City. 
MixBon, William Daniel, mc Chattanooga 98, cb 98, Haw Ridge. 
Norris, Roy Hart, mc Alabama 97, cb Monroe 97, Charlton. 
Gates, Joshua Camillus, mc univ Tennessee 98, State Board 98,. 

Pinckard. 
Powell, Charles B, mc Alabama 1900, cb Geneva 1900, Skipperville. 
Reynolds, Robert Davis, mc Alabama 80, cb 87, Ozark. 
Tarbrough, Frank Reid, mc univ Vanderbilt 98, cb Crenshaw 98^ 

Ozark. 

Total, 14. 

PHYSICIANS KOT MEMBERS OF THE SOCIETY. 

Baxter, Hugh Curry, mc Atlanta 86, cb 87, Midland City. 

Bell, Seaborn Bentley, mc Georgia Reform 92, cb 95, Echo. 

Dalton, Christopher Columbus, mc Georgia Reform 91, cb 91, Wicks^ 
burg. 

Dawson, George Washington, mc Alabama 94, cb Chilton 94, Newton. 

Davie, Mercer Stillwell, mc Jefferson 67, cb 87, Pinckard. 

Lingo. John Henry, ng, State Board 97, Clayhatchie. 

Morris, Andrew Jackson, mc Atlanta Southern 7, cb Geneva 889. 
Newton . 

Scott, Marcus Tullius Cicero, mc Birmingham 97, cb Henry 97, Clop- 
ton. 

Spears, Philip Benton, mc Georgia Reform 91, cb 91, Pinckard. 

Weed, Samuel LaFayette, mc Alabama 85, cb 87, Ariosto. 
lotal, 10. 

Retired — Bottoms, James Augustus, 56, cb 87, Ozark, Holman, 
John Clinton, mc Jefferson, 56, cb 87, Ozark. 

Moved into the county — Frank, Reid Yarbrough, from Victoria* Cof- 
fee county, to Ozark; Charles B. Powell, from Slocum, Geneva 
county, to Skipperville. 

Moved out of the county — William Ree Belcher, from Dalcville to 
Hartford, Geneva county. 

DALLAS COUNTY MEDICAL SOCIETY— Montgomery. 1875. 

OFFICERS. 

President, W. M. Pitts; Vice-President, Jas. M. Donald; Secre- 
tary, B. B. Rogan; Treasurer, S. Kirkpatrick; Health Officer, S. 
O. Gay. Censors — J. P. Fumiss, E. B. Ward, C. Ritter, S. O. 
Gay, Jas. M. Donald. 



THE ROLL OF THE COUNTY SOCIETIES. I73 

NAMES OF MEMBERS WITH THEIR COLLEOES AND PCN3T-0FFICES. 

.Allison, Samuel Blakeman, mc Louisyille 91, cb 93, Carlowville. 

Caine, Vaughn Holmes, mc Alabama 92, cb Perry 92, Saflord. 

Cniapman, John Thomas, mc Alabama 85, cb Marengo 87, Selma. 

€k>chrane, Robert Miller, mc uniy Virginia 65, cb 78, Eleanor. 

Donald, James Marion, mc Alabama 84, cb 84, Bridges. 

Donald, Joseph Marion, mc univ Louisiana 54, cb 78, Howell. 

DuBose, Frank Goodwin, mc Tulane 93, cb Talladega 93, Selma. 

Bdwards, Daniel B., mc Alabama 98, cb 98, Polk. 

Fumiss, John Perkins, mc univ New Orleans 66, cb 78, Selma. 

Gay, Samuel Gilbert, mc Alabama 87, cb 87, Selma. 

Gee, William Henry, mc Alabama 98, cb Mobile 98 ,Bumsyille. 

Groves, Joseph Asbury, mc South Carolina 54, cb 78, OrrviUe. 

Harper, William Wade, mc Tulane 91, cb 91, Selma. 

Howard, Thomas Greenwood, mc univ Washington 68, cb Autauga 
78, Selma. 

Kendall, William Quinton, mc Phys. and Surg. Baltimore 80, cb 80, 
Berlin. 

King, Goldsby, mc South Carolina 80, cb 80, Selma. 

Kirkpatrick, Samuel, mc univ Vanderbilt 88, cb 88, Selma. 

Kyser, James Hervey, mc univ Tulane 97, cb 97, Richmond. 

Lockhart, Thomas Earnest, mc univ Tulane 90, cb Perry 90, Selma. 

Moore, John Thomas, mc Alabama 91, cb 91, Orrville. 

Peagues, Charles Ives, mc univ Tulane 93, cb 96, Saflord. 

Phillips, William Crawford, mc Tulane 73, cb 78, Vallegrande. 

Pitts, William McLean, mc unic Louisville 94, cb 94, Selma. 

Riggs, Samuel Wait, mc Phys. and Surg. Baltimore 93, cb — , Pleas- 
ant Hill. 

Ritter, Clement, mc Jefferson 90, cb DeKalb 90, Selma. 

Rogan, Barney Bums, mc univ Grant 96, cb 96, Selma. 

Sellers, Wm. Thomas, mc Alabama, 92, cb Bibb 92, Browns. 

Sutton, Robert Lee, mc univ Columbia 89, cb Lee 89, OrrviUe. 

Taylor, William Henry, mc Alabama 87, Marengo 87, Central Mills. 

Ward, Edward Burton, mc univ New York 82, cb Hale 82, Selma. 
Total, 30. 

PHYSICIANS NOT MEMBERS OF THE SOCIETT. 

Allison, Joseph D. (retired), mc South Carolina 78, cb 78, Carlow- 
ville. 

Boykin, Joseph Owen, mc Transylvania 43, cb 78, Tilden. 

Boykin, Samuel Swift, mc Alabama 96, cb Mobile 98, Portland. 

Burwell, Lincoln Laconia (col.), mc Leonard N. C. 89, State Board 
89, Selma. 



174 ^^^ MEDICAL AaaOCIATION OF ALABAMA, 



Dye, J. H., mc Eclectic, New York . 

DuBose, J. J., mc , cb — , Summerfield. 

Fuller, Bmmet Lee, mc Alabama 1900,. cb 1900, Summerfield. 
Hall, John James, mc unlY Louisiana 67, eb 78, OrrriUe. 
Kyser, George Washinston, mc Rickmond 65, cb 78, Richmond. 
Moore, John Welsey (col.), mc Meharry 99, cb Clark 99, 



Moseley, Elijah Bucklee, mc unlv Louisiana 67, eb 78, Boguechitto» 
Pugh, Braxton Bragg, mc Alabama 89, cb Clark 89, Browns. 
Stewart, William Champney, mc South Carolina 58, cb 78, Soap Stones 
Total, 13. 

Moved into the county — ^B. L. Fuller, from Perry county to Su]n^ 
merfleld. 

Examinations — ^William Bradley Paliner, mc uniy Tulane, certUK 
cate granted; Emmet Lee Fuller^ mc Alabama 1900, certificate 
granted; Carlyle Keyser Yates, mc Baltimore 1900, certificate 
granted. 

Deaths — John Alexander McKinnon, nephritis, Sellna; John Alonsa 
Weisinger, tuberculosis, Talmage; Kenneth McKinnIn, Pleasant 
Hill. 

DeKALB county MEDICAL SOCIETY-^Greenville, 1885. 

OFFICERS. 

President— H. P. McWhorter; Vice-President, W. I. Wright; Sec- 
retary, W. E. Quinn; Treasurer, T. H. Appleton; Health Ofllcerr 
E. P. Nicholson. Censors— W. E. Quinn, W. S. Duff, T. H. Apple- 
ton, H. P. McWhorter, E. P. Nicholson. 

NAMES OF MEMBERS WrTH THEIB 00LLBQB8 AND FOSTKirFICBS. 

Appleton, Thomas Hajme, mc Chattanooga 92, cb 92, CollinsvlUe. 

Black, John Hugh, mc Georgia Eclectic 93, cb 93, Halford. 

Duff, William Sayers, mc Alabama 89, cb 90, Ft. Payne. 

Elrod, James Tolliver, mc uniy of the South 1900, cb Marshall 1901, 

South Hill.. 
Harrison, Joseph J., mc uniy Vanderbilt 93, cb 93, Geraldine. 
Killian, Henry Elliott, ng, cb 89, Brandon. 
McWhorter, Horace Puckett, mc uniy Vanderbilt 81, cb 85, Colllns- 

ville. 
Miller James Taylor, mc uniy Vanderbilt 78, cb 85, Collinsyllle. 
Moore, Wiley Eyan, mc Atlanta 90, cb Shelby 90, Lebanon. 
Nicholson, Edward Pierson, mc uniy Nashyille 61, cb 85, Valley Head. 
Quin, William Eyerett, mc Kentucky s of m 81, cb 85, Ft. Payne. 
Sherman, James Richard, mc Georgia Eclectic 89, cb Marshall 89» 

Sand Mountain. 



THE ROLL OF THE COUNTY SOCJETIB8. I75, 

Wright, William Ira, mc nniv of Vanderbilt 90, cb 91, Dawson. 
Wright, Charles Wesley, mc Alabama 98, cb 98, South HUL 
Total, 14. 

PHYSICIANS NOT MBMBEBS OF THK 80CUTT. 

Bailey, Alexander Henry, ng, cb 89, Chayles. 
Bogle, Joseph H., mc Vanderbilt 1900, cb 1900, Chavies. 
Bush, Qeorge Volney, mc Southern — , cb ICarshall 99, Lebanon.. 
Qreen, Philmon Buel, mc univ Vanderbilt 76, cb 86, Ft. Payne. 
Green, William Martin, mc univ Vanderbilt 77, cb 85, Ft. Pasme. 
Hall, John Decard, mc Southern 92, cb 97, Chayles. 
Howard, Joshua Elijah, mc univ Tennessee 86, cb 96, Henegar. 
Smith, Samuel Parish, mc Kentucky c of m 89, cb 89, Crossrille. 
Smith, William A., Proforma Certificate, cb Coosa 93, Luttrell. 
Winston, John Nelson, mc LouisYille 66, cb 86, Valley Head. 
Wyatt, J. J. ng, cb 89, Oeraldine. 
Total, 11. 
Moved into the county — Qeorge V. Bush, from Georgia to Lebanon r 
Sidney J. Vann, from to Rock Springs. 

Moved out of the county — Isaac William Howard, from Sulphur 
Springs, to Madison, Madison county. 

Bxamlnatlons — Joseph H. Bogle, certificate granted; Sidney John^ 
ston Vann, mc (Georgia 1900, certificate granted. 

Death — William Jones Wooten, ng, cb 89, Musgrove. 

ELMORE COUNTY MEDICAL SOCIETY— Birmingham, 1887. 

omcsBSw 

President, W. A. Huddleston; Vice-President, J. W. Sewell; Secre^ 
tary, W. M. Gamble; Treasurer, W. M. Gamble; Health Officer, S. 
O. Humphries. Censors — O. S. Justice, J. T. Rushin, S. O. Humph- 
ries, W. H. Blake, J. A. Howie. 

NAMES or MBMRICBS WITH THEIR OOLLEGES AND FOBTOIVIGES. 

Blake, Wyatt Heflin, mc univ Vanderbilt 84, cb Randolph 87, We> 
tumpka. 

Estes, Mordeca James Elliot, mc Atlanta 96, cb 96, Deatsville. 

Fltzpatrick, Phillip, mc Tulane 63, cb 84, Wetumpka. 

Gamble, William Melvin, mc LouisTille 87, cb JefTerson 87, We- 
tumpka. 

Garrett, Allen Jefterson, mc Alabama 93, cb 93, Kent. 

Howie, James Augustus, mc Alabama 90, cb 90, Eclectic. 

Huddleston, Wm. Allen, mc Atlanta 80, cb 84, Wetumpka. 

Humphries, S. Osceola, mc JefTerson 86, cb 86, Speigner. 

Justice, Oscar Suttle, mc Alabama 86, cb 86, Central. 



176 ^^^ MEDICAL ASSOCIATION OF ALABAMA. 

Mllner, Samuel Robert, mc Alabama 93, cb 94, Jordan. 

Moon, Eddie P., mc univ Vanderbllt 98, cb 98, Buyck. 

Nlz, James Ringold, mc South Carolina 67, cb 84, DeatsYlUe. 

Robinson, Edwin Hunt, mc Memphis Hospital 49, cb 84, Robinson 

Springs. 
Scott, Harvey Edward, mc unly Vanderbllt 80, cb Dallas 80, We- 

tumpka. 
Sewell, Japez Wesley, mc Alabama 90, cb 90, Titus. 
Sewell, Neal Baker, mc unlv Vanderbllt 86, cb 86, Buyck. 

Total, 16. 

Honorary Member, 
Gamble, John Wesley, mc Louisville 72, cb Blount 74, Wetumpka. 

PHYSICIANS KOT MEMBEBB OF THE SOCIETY. 

Beckett, Thomas Travis, mc Tulane 59, cb 84. Titus. 
Boddle, Henry B., (Illegal), Tallassee. 
Campbell, Archie Graham, ng, cb 84, Tallassee. 
Dorough, John William, mc Atlanta 94, cb 94, Tallassee. 
Fielder, Martin Lucius, mc Graffenburg 59, cb 84, Eclectic. 
Huddleston, Robert Lee, mc Atlanta 80, cb Autauga 92, DeatsviUe. 
Jowers, Sol. Franklin, mc Alabama 85, cb 85, Central. 
Lett, Harrison Templeton, mc Tulane 75, cb 84, Good Hope. 
Cowell, James Robert (retired), mc Graffenberg 65, cb 84, Tallassee. 
Powell, Abel Anderson (retired), mc Atlanta Southern 92, cb 92, 

Tallassee. 
Robinson, Dudley, mc Alabama 51, cb — , Robinson Springs. 
Rushln, James Thomas, mc unlv Tennessee 83, cb 84, Tallassee. 
Warren, William Allen, mc Alabama 85, cb 85, Tallassee. 

Moved out of the county — ^J. M. Wallace, from Tallassee to Montgom- 
'Ory ; W. H. Blake, from Wetumpka to Sheffield, Colbert county; James 
Robert Halgler, from Wetumpka to Dayton, Marengo county; Robert 
Daniel Howe, from Elmore to L<ee county. 
Total, 13. 

Examinations — ^James Marvin Wallace, Vanderbllt 1899, certificate 
granted; J. W. Maddox, mc unlv Tennessee 1900, certificate granted; 
Jessie Gulledge, mc Alabama 1900, certificate granted; E. N. Rawls, 
mc Vanderbllt 1896, certificate granted; Joseph O. Dennlson, mc Van- 
derbllt 1893, certificate refused. 

Death»— Robert McCullough Hill, mc Alabama 94, cb 96, Ware, 
remittent fever. 

ESCAMBIA COUNTY MEDICAL SOCIETY— Greenville, 1885. 

OFFICEBS. 

President, S. C. Henderson; Vice-President, J. E. Martin; Secre- 
-^^^l P. H. M. Tlppin; Treasurer, P. H. M. Tlppln; Health Officer, 



THE ROLL OF THE COUNTY SOCIETIES. ]77 

P. H. M. Tippin. Censors — S. C. Henderson, E. T. Parker, M. 
Foshee, W. L. Abemathy, P. H. M. Tippin. 

NAMES OF MEMBERS WITH THEIB COLLEGES AND POST-OFFICES. 

Abemathy, William L., me Alabama 94, cb Monroe 94, Flomaton. 
Abemathy, William Henry, mc Transylvania 48, cb Monroe 77, 

Flomaton.^ 
Foshee, Mason, mc univ Virginia 96, cb 96, Brewton. 
Henderson, Stephen Gary, mc Alabama 87, cb 87, Brewton. 
Malone, Henry Hplcombe, mc univ New York 60, cb 86, Brewton. 
Martin, John Elijah, mc Alabama 75, cb Bullock 79, Brewton. 
Parker, Edwin Theodore, mc Tulane 91, cb 91, Brewton. 
Smith, Price Hall, mc Alabama 94, cb 94, Brewton. 
Smith, Russell Aubrey, mc Alabama 1900, cb Monroe 1900, Hammaa 
Tippin. Philip Henry Mulcahy, mc Alabama 94, cb 94, Brewton. 
Webb, Alfred Pellar, mc Alabama 96, cb Washington 97, Atmore. 

ToUl, 11. 

PHYSICL4NS NOT MBMBEB8 OF THE BOOHTT. 

Christian, , mc — , cb — , Jack Springs. 

Ford, J. T. B., mc — , cb 86, Pollard. 

Kelley, Edward, mc , cb — , Hammac. 

Owens, Jared Durwood, mc Alabama 79, cb Butler 79, Pollard. 
McClendon, Lewis Marshall, mc Alabama 74, cb Butler 84, Brewton. 
Total, 5. 

Moved into the county — Edward Kelley; Russell A. Smith, from 
Monroe county to Hammac. 

ETOWAH COUNTY MEDICAL SOCIETY— 1878. 

OFFICEBd. 

President, J. P. Ralls; Vice-President, E. T. Camp; Secretary, 
R. F. McConnell; Treasurer, E. S. Jones; Health Officer, E. T. 
Camp. Censors — ^E. S. Jones, J. W. Lawrence, F. P. Landers, W. 
H. Acton, J. P. Stewart 

NAMES OF MEMBERS WITH THEIB COLI^EOES AND POST-OFFICES. 

Acton, Wm. H., mc Alabama 86. cb Jefferson 86. Alabama City. 

Baskin, Herchell Virgil, mc Alabama 98, cb 98. Coats Bend. 

Camp, Erasmus Taylor, mc univ Vanderbilt 88, cb Lauderdale 88, 

Alabama City. 
Ellison. John Henry, mc univ Vanderl^ilt 88, cb 89, Walnut Grove. 
Gulce, Chas. Lee, mc Chattanooga 93, cb Dale 93, Gadsden. 
Jones, Eli Spear, mc Alabama 83, cb Jefferson 83, Gadsden. 
Landers, Franklin Pearce, mc Atlanta 83, cb 84, Hokes Bluff. 
Lawrence, John William, mc uniy VaQderbllt 86, cb Cherokee 86, 

Turkey Town. 

12 



178 THE MEDICAL ASSOCIATION OF ALABAMA. 

Liddell, John Brown, mc Atlanta 82, cb 82, Gadsden. 

McConnell, Robert Franklin, mc Atlanta 81, cb St Glair 81, Attalla. 

Ralls, John Perkins, mc Georgia 44, cb 78, Gadsden. 

Stewart, John Pope, mc Alabama 86, cb 86, Attalla. 

Vann, Sidney Johnston, mc Georgia 1900, cb DeKalb 1900, Rock 

Springs . 
Wilson, George Washington, mc Alabama 95, cb 96, Attalla. 
Wood, James Harden, mc univ Vanderbilt 82, cb 82, Attalla. 

Total, 15. 

PHTSICIANS NOT MEMBEBS OF THE SOCIETY. 

Anderson, Robert Bailey, mc Atlanta — , cb 88, Walnut Grove. 
Baker, Daniel Harrison, mc univ Vanderbilt 82, cb 82, Gadsden. 
Goggins, Wm. Thomas, mc South Carolina — , cb 88, Keener. 
Dowdy, Edgar Lee, mc univ Vanderbilt 76, cb 76, Keener. 
Edwards, Wm. Sterling, Kentucky, s of m 85, cb 85, Gadsden. 
Ford, Wm. Franklin, mc univ Vanderbilt 95, cb 95, Hokes Bluff. 
Funderberg, Wm. Louis, mc Atlanta Southern 82, cb DeKalb 82. 
Gilliland, Henry Forney, mc Louisville 90, cb — , Hill. 
Hawkins, J. P., mc Ghattanooga, 94, cb Jefferson 94, Glear Springs. 
Hurst, James A., mc Alabama 91, cb 91, Walnut Grove. 
Kinnett, Jackson Flavls, mc Georgia Eclectic 92, cb Shelby 92, 

Markton. 

Lester, J. H., mc , cb — , Attalla. 

Morgan, George Washington, mc univ Nashville 89, cb 89, Keener. 
Plaine, Gharles (col.), mc Meharry 1900, State Board 1900, Gadsden. 
Slaughter, Gharles Jefferson, mc , — , cb 81, Aurora. 

Total, 15. 

Moved into the county — Henry Forney Gilliland, from Kentucky, 
to Hill; J. P. Hawkins, from St. Glair to Glear Springs. 

Moved out of the county — R. D. Blackshear, from Gadsden to Do- 
than, Henry county; Robt. M. Dowdy, from Legard to Gherokee 
county; E. J. Edwards, from Cobb City to Calhoun county. 

Examinations — ^Wm. Henry Coleman (col.), Meharry 1900, certifi- 
cate withheld because applicant violated law by applying for exami- 
nation to this board in less than twelve months from date of his 
examination by Hale county board. 

FAYETTE COUNTY MEDICAL SOCIETY— Selma, 1879. 

OFFICEBS. 

President, J. D. Young; Vice-President, J. G. Smith; Secre- 
tary, W. A. Graham; Treasurer, W. A. Graham; Health Oflicep, 
M. R. Seay. Censors— Victor Savage, J. D. Young, J. G. Smith* 
J. F. Randolph, W. A. Graham. 



THE ROLL OF THE COUNTY SOCIETIES. 179 

NAMES OF MKMBEBS WITH THEIB OOIXBQBS AND POSTKOTICES.. 

Collins, J. William, Old Law, cb 84, Spencer. 

Graham, Wm. Alexander, mc Louisville 92, cb 92, Fayette. 

Hocutt, Lucius Thornton, mc Atlanta 58, cb 84, Davis Creek. 

Hollis, Jonathan Shelton, mc Alabama 81, cb Lamar 81, Covin; 

Jones, Wm Wilbum, Old Law 58, cb 84, Newtonville. 

Jones, Tarley William, mc Vanderbilt 1900, cb 1900, Newtonville. 

Randolph, John Franklin, mc Memphis Hospital 99, cb 99, Wayside. 

Savage, Victor, mc Vanderbilt 89, cb 89, Pilgrim. 

Smith, John Gardner, mc Alabama 89, cb Lamar 89, Bankston. 

Seay, Mark Rollins, Old Law 79, cb Lamar 86, Berry Station. 

Young, James Dopsie, mc Memphis Hospital 84, cb Lamar 94» 

Fayette. 

Total, 11. 

PHYSICIANS NOT MEMBEB8 Or THE SOCIErT. 

Lane, Jesse Washington, mc Vanderbilt 86, cb Walker 86, New River. 
Martin, Thos. Hix, Old Law, cb Cleburne — , Ballard. 
Total, 2. 

Moved into the county — James Lucien Batson, from Jefferson 

county to ; Wm. Wallace Duncan, from Pickens county 

to Berry. 

Moved out of the county — James Lucien Batson, to Jefferson 
county; Wm. Wallace Duncan, from Berry to Pratt City, Jeffersoiv 
county; Thos. M. Peters, from Fayette to Birmingham. 

Examinations — James Lucien Batson, mc Vanderbilt 1900, cer- 
tificate granted; Wm. Wallace Duncan, mc Birmingham, 1900, cer- 
tificate granted; Tarley William Jones, mc Vanderbilt 1900, cer- 
tificate granted. 

•FRANKLIN COUNTY MEDICAL SOCIETY— Tuscaloosa, 1887. 

0FFICEB8. 

President, J. M. Clark; Vice-President, W. W. White; Secretary, 
W. J. Clark; Treasurer, W. J. Clark; Health Officer, L. W. Despres. 
Censors — L. W. Despres, N. T. Underwood, J. A. Trimble, O. Sar- 
gent, B. M. Harris. 

NAIOBS or MBMBEBB WITH THKIB OOIUMXS ASD POSTOniJGBB. 

Barnes, Thomas Benton, mc Memphis 74, cb 88, Darlington. 
Clarke, John King, Sr., mc univ Nashville 68, cb 88, Russellville. 
Clarke, John King, Jr., mc univ Vanderbilt 84,. cb 88, Belgreen. 
Clark, John McWhorter, mc univ Louisville 50, cb Lawrence 
88, Russellville. 



,180 ^^^ MEDICAL ASSOCIATION OF ALABAMA, 

Clark, William Josiah, mc Birmingham 96, cb 96, R'uBsellTille. 

Cleere, William Washington, mc univ Nashyllle 82, cb 88, Belgreen. 

Desprez, Louis WiUoughby, mc Alabama 71, cb 88, Russellville. 

Harris, Elijah McCulloch, mc univ Vanderbilt 87, cb 87, Russellville. 

Hughes, , mc , cb , Pleasant Site. 

Jones, Thomas Speck, mc univ Vanderbilt 78, cb 88, Russellville. 

Lee, , mc , cb , Red Bay. 

Nance, James W., mc Baltimore 94, cb — , Russellville. 

Sargent, Oscar, mc univ Vanderbilt 80, cb 88, Darlington. 

Trimble, Joseph Adison, mc Vanderbilt 81, cb — , Russellville. 

Underwood, Nimrod Terrell, mc Alabama 86, cb 88, Russellville. 

White, William Wyatt, mc s of m Kentucky 85, cb Marion 85, New- 
burg. 

White, Robert Josiah, mc Louisville 54, cb 88, Burleson. 
Total, 17. 

PHTSICIANS XOT MEMBERS OF THX 80GIETT. 

Sevier, Daniel Vertner, mc — , cb — , Russellville. 
Total. 1. 

^NoTE — As no report has been received from Franklin county this 
year, the report for 1900 is here reproduced. 

GENEVA COUNTY MEDICAL SOCIETY— Montgomery, 1888. 

OFFIGEBS. 

President, A. B. Jemigan; Vice-President, J. N. Clements; Sec- 
retary, C. B. McKinnon; Treasurer, C. B. McKlnnon; Health 
Officer, E. Y. Malone. Censors — M. F. Fleming, R. L. Justice, 
C. B. McKinnon, B. Y. Malone, J. C. Fleming. 

NAMES OF MEMBERS WITH THEIB OOLLBOSS AND POST-OFFIOKS. 

Ard, James Henry, mc Alabama 88, cb 88, Geneva. 
Belcher, William Ree, mc Kentucky s of m 91, cb Dale 91, Hartford. 
Campbell, Terrell Taylor, mc Atlanta 83, cb Dale 87, Hartford. 
Chalker, William Pounce, mc Georgia Eclectic 97, cb 97, Sanders. 
Chapman, Abner Richard, mc univ Vanderbilt 88, cb CofFee 88, 

Geneva. 
Chapman, William Hickerman, mc Alabama 73, cb ColEee 88, Geneva. 
Clements, John N., mc Jefferson 56, cb 88, Flat. 

Cox, William, mc , cb 88, Dundee. 

Douglass, Silas William, ng, cb Escambia 87, Eunola. 
Fleming, John Clifton, mc Alabama 91, cb 95, Hartford. 
Fleming, Milliard Filmore, mc Louisville — , cb 88, Geneva- 
Jay, John D., mc , Pro forma certificate, Elton. 



THE ROLL OF THE CODNTT SOCIETIES. 181 

Jemigan, Alpheus Baker, mc , cb 88, Geneva. 

Justice, Robert Lee, mc Alabama 94, cb Pike 94, Oeneva. 
Malone, Eugene Tewell, mc Alabama 92, cb Escambia 92, Geneya. 
McKinnon, Charles Braxton, mc Tulane 92, cb 1900, Geneva. 
RlTonbark, Jackson John, mc Georgia Eclectic 97, cb Dale 97, Hart* 

ford. 
Rivenbark, Oscar Lee, mc Georgia Eclectic 93, cb 1900, High Note. 

Shute, Joseph V., mc , cb 88, Lupton. 

Smith, Gordon Wright, mc Louisville 92, cb 92, Big Creek. 
Treadwell, Hardy P., mc Georgia Eclectic 98, cb 88, Geneva. 
Ward, Thomas Jefferson, mc , cb 88, Watford. 

Total, 22. 

PHTSICIANS NOT MEMBERS OF THE 800ISTT. 

I 

Johnston, John, illegal, Flat. 
Ramsay, Walter Dekel, ng, illegal, Whittaker. 
Robertson, J. B., illegal, Sanders. 
Smith, William W., illegal, Coftee Springs. 
Smith, Dave, illegal, Sanders. 
Total, 5. 

Moved into the county — C. B. McKinnon, from Pensacola, Fla.» 
to Geneva; T. T. Campbell, from Echo, Dale county, to Hart- 
ford; William Ree Belcher, from Daleville, Dale county, to Hart- 
ford. 

Moved out of the county — George H. Blackshear, from Dundee to 
Gordon, Henry county; John H. Holly, from Marl to Opp, Coving- 
ton county; William A. Hooten, from Hartford to ; Charlea 

B. Powell, from Sanders to Pansey, Henry county. 

Examinations — Charles Braxton McKinnon, mc Tulane 1892, cer- 
tificate granted; Charles Bob Powell, mc Alabama 1900, certificate' 
granted; Oscar Lee Rlvenbark. mc Georgia Eclectic 93, certificate 
granted; W. W. Smith, certificate refused. 

•GREENE COUNTY MEDICAL SOCIETY— Selma, 1878. 

OFFICERS. 

Prealdent, J. P. Barclay; Vice-President, A. H. Byrd; Secretary^ 
W. R. Hatter; Treasurer, W. R. Hatter; Health Officer, . Cen- 
sors — A. M. Duncan, R. D. Lucius, S. S. Murphy, D. 0. McGhee, A. 
P. Smith. 

NAMES OF MKMBEBS WnH THEIB COLLEGES AND P08TK>FFI0I8. 

Barclay, James Paxton, mc unlv New York 71, cb 79, Eutaw. 
Byrd, Alexander Hamilton, mc unlv New York 69, cb 80, Eutaw» 



182 THE MEDICAL ASSOCIATION OF ALABAMA. 

Dnncan, Augustus Meek, mc Alabama 74, cb 79, West Greene. 
Gunter, John Leon, mc Memphis 94, cb Pickens 95, Eutaw. 
Harkness, William Baskln, mc Alabama 97, cb 97, Bollgee. 
Hatter, William Reuben, mc unlv Tulane 89, cb 89, Bollgee. 
Hagler, John Wiley, mc Alabama 94, cb Tuscaloosa 94, Clinton. 
Legare, Julius Kenneth, mc unlv New York 86, cb 87, Forkland. 
Lucius, Richard DeKalb, mc Alabama 71, cb Tuscaloosa 78, Butaw. 
McGehee, Dabney Oswell, mc Alabama 72, cb 79, Eutaw. 
Moore, George Augustus, mc Alabama 90, cb 90, Clinton. 
Murphy, Samuel Sllenus, mc Alabama 81, cb 84, Pleasant Ridge. 
Pierce, Thomas William, mc unlv Virginia 75, cb 79, KnozTlUe. 
Smith, Armand Pfister, mc s of m Kentucky 75, cb 79, Eutaw. 
Smith, John Alexander, mc Atlanta 58, cb 79, Union, 
finoody, Virgil, mc Alabama 73, cb 79, KnoxTllle. 
Total, 16. 

PHYSICIANS NOT MESCBEBS OF THX 80GIETT. 

Morgan, Isaac DuBose, mc unly Pennsylvania 58, cb 79, Eutaw. 

Mobley, W. A., mc Alabama — , cb — , West Greene. 

Pearson, Edward Pallen, mc unlv Louisville 73, cb 84, McAlplne. 

Pumell, James Knox, mc , cb Pickens 88, Lewlston. 

Snoddy, Samuel, mc unlv Transylvania 31, cb 79, Mantua. 
Total, 6. 

*NoTE — ^As no report has been received from Greene county this 
7ear, the report of 1900 Is here reproduced. 

HALE COUNTY MEDICAL SOCIETY— Montgomery, 1875. 

OFFICERS. 

President, M. W. Leonard; Vice-President, H. T. Young; Sec- 
retary, H. G. Perry; Treasurer, H. G. Perry; Health Officer, Jacob 
Hugglns. Censors — E. P. McCollum, Jacob Hugglns, R. H. Dug- 
sar, H. G. Perry, J. P. Borden. 

NAMES OF MEMBEBS WITH THEIB COLLEGES AND POST-OFFICES. 

Abemathy, Thomas Plnnlc, mc Memphis Hospital 99, cb 99, Havana. 
Borden, James Pennington, mc Southern 75, cb 78, Greensboro. 
Davis, Andrew Rufus, mc Atlanta 90, cb 90, Five Mile. 
Driver. EUsha Newton, mc Louisiana 93, cb 93, Newbern. 
Duggar, Reuben Henry, mc Pennsylvania 58, cb 78, Galllon. 
Oewen, Wm. Christopher, mc unlv Louisiana 78, cb 78, Akron. 
Griffin, Rufus Jackson, mc Alabama 90, cb 90, Moundvllle. 
Hugglns, Jacob, mc Pennsylvania 60, cb 78, Newbern. 
Lieonard, Madison Waldo, mc Alabama 94, cb 94, CedarvUle. 



THE ROLL OF THE COUNTY SOCIETIES. 183 

McCoUum, Edsar Patton, mc Alabama 93, cb Peny 93, Greenaboro. 

McGehee, John Webb, mc Tulane 1900, cb 1900, Qreensboro. 

Otts, Mark Christleab, mc Alabama 1900, cb 1900, Greensboro. 

Ferry. Henry Gaither, mc Georgia Reform 88, cb Butler 88, Greens- 
boro. 

Spencer, George M., ng (Old Law), cb Tuscaloosa 78, Brush Creek. 

Thurmond, Wm. H., mc Southern 86, cb Tuscaloosa 96, Moundyille. 

TIdmore, Dodson Wright, mc unic of South 99, cb 99, Phlpps. 

Toung, Henry Tutwiler, mc uniy of South 99, cb 99, Greensboro 
Total, 17. 

Honorary Meml>€rs 

Downey, Wm. Thomas, Old Law, cb 70, Scotts. 

Webb, Louis DeTampert, uniy New York 69, cb 78, Greensboro. 

PHTSICIAHS NOT ME1CBBB8 OF THS SOCIETT. 

Carson, Shelby Chadwlck, mc Tulane 74, cb Greene 79, Greensboro. 
Harris, John Reed, mc Memphis 96, cb Jefferson 96, Greensboro. 
Total, 2. 

Moyed into the county — J. W. McGehee, from New Orleans, La., 
to Greensboro; J. R. Harris, from Waxohachee, Texas, to Greens- 
t>oro; W. H. Thurmond, from Duncanyille, Tuscaloosa county, to 
Moundyille. 

Moyed out of the county — L. W. McGruder, from Greensboro to 
Mississippi; J. U. Ray, Jr., from Greensboro to Woodstock, Bibb 
county; John H. Owens, to Scottsyille, Bibb county; Wm. H. Cole- 
man (col'd.), from Greensboro to Gadsden, Etowah county. 

Examinations — ^Wm. H. Coleman, (col'd.), Meharry 1900, certifi- 
cate refused; M. C. Otts, mc Alabama 1900, certificate granted; L. 
8. Brown, mc Alabama 1900, certificate granted; J. Webb McGehee, 
mc Tulane 1900, certificate granted; Wm. S. Anderson, mc Tulane 
1900, certificate granted. 

Deaths — ^T. F. Moore, Stewarts, died Dec., 1900 of acute dysen- 
tery; J. A. Tidmore, Hayana, pneumonia, Noy., 1900. 

HENRT COUNTY MEDICAL SOCIETY— Birmingham, 1883. 

OFTICEBS. 

President, W. M. Ryals; Vice-President, G. A. Hammond; Sec- 
retary, Henry Green; Treasurer, H. P. Calhoun; Health Officer, 
W. M. Ryals. Censors— G. A. Hammond, J. R. G. Howell, S. O. 
Carlisle, W. J. Lee, J. H. Stoyall. 



184 "^^^ MEDICAL ASSOCIATION OF ALABAMA. 

ITAMES OF M1CMWIEB8 WITH THEIB 00LLBGB8 AND POSTOITZGBS* 

Atkeson, Clarence Lee Crawford, mc Phys. and Surg. Baltimore 84, 

cb Lee 86, Columbia. 
Burdeshaw, Lee Roy, mc Chattanooga 99, cb 99, Headland. 
Calhoun, Henry Paulden, mc Atlanta 95, cb 96, Cottonwood. 
Carlisle, Samuel Oscar, mc Vanderbllt 94, cb Pike 94, Dothan. 
Davie, Mercer StiUwell, mc Tulane 99, cb Bibb 99, Dothan. 
Ellis, James Lewis, mc Memphis Hospital 86, cb Dale 86, Dothan. 
Fowler, James Thomas, mc South Carolina 81, cb 81, Shorteryille. 
Green, Henry, mc Alabama 92, cb Conecuh 92, Dothan. 
Hammond, George Abner, mc Phys. and Surg. Baltimore 84, cb 84» 

Dothan. 
Hardwick, William Pleasant, mc Alabama 67, cb 88, Headland. 
Hendrix, Leonidas, mc Atlanta 90, cb Pike 90, Abbeville. 
Howell, John Robert Graves, mc Atlanta 90, cb Dale 88, Dothan. 
Lee, William Joseph, mc univ Louisiana 60, cb 83, Abbeville. 
Long, James Benjamin, mc Louisville 81, cb 83, Abbeville. 
Nichols, Lucius Sherman, mc Alabama 97, cb 97, Abbeville. 
Payne, John Walter, mc Alabama 86, cb 87, Dothan. 
Phillips, Bernard, mc Heidelberg Germany 74, cb 91, Dothan. 
Ryals, William M., mc Atlanta 87, cb 95, Cowarts. 
Stovall, John Henry, mc Atlanta 60, cb 89, Columbia. 
Steagall, Wm. Collingsworth, mc South Carolina 60, cb 87, Abbeville. 
Steagall, Albert Sidney, mc Alabama 88, cb Dale 87, Abbeville. 
Vaughn, David Horatio, mc Atlanta 88, cb 89, Gk>rdon. 
Williams, Wm. Henry, mc Memphis Hospital 89, cb 89, Dothan. 

Total, 28. 

Honorary Member. 
Lee, Joseph Edward, mc Atlanta 95, cb 97, Waycross, Ga. 

PHYSICIANS NOT MEMBERS OF THE SOCIETY. 

Blackledge, John Richard, mc Alabama 89, cb 91. Abbeville. 
Blackshear, Randall Davis, mc Kentucky s of m 92, cb Dale 94, 

Dothan. 
Chalker, B. C, mc Eclectic — , (illegal), Cottonwood. 
Fowler, John Lindsey, mc South Carolina 51, cb 83, ShorterviUe. 
Fillingim, W. H., ng, (illegal), Ashford. 
Hill, Amon S., mc Atlanta (illegal). Granger. 
Kennedy, Thomas Joseph, mc univ of South 99, cb 1900, Gordon. 
Lewis, James Langdon, mc Atlanta 84, cb 85, Bush. 
McElvin, Pleas., ng, (illegal), Ashford. 
McElvin, , ng, (illegal), Lawrencevllle. 



THE ROLL OF THE COUNTY SOCIETIES. 185 

Oates, Wyatt Stephen, mc , cb 91, Headland. 

Pate, Walter Eugene, mc Atlanta 93, cb 96, Ashford. 
Stokes, James Bldridge, mc Georgia Eclectic 92, cb 97, Kinsey. 
Sporman, Charles F., mc A^^bama 87, cb 89, Headland. 
Vann, James Robert, mc Alabama 99, cb 1900, Haleburg. 
Weems, William S., mc Alabama 92, (Illegal), Lawrenceville. 
Toung, Harry Monroe, mc Alabama 93, cb 93, Dothan. 
Tarborongh, Jno. T., mc Atlanta 92, cb 92, Columbia. 
ToUl, 18. 

Moved into the county — ^Henry Oreen, from Boiling, Butler coun-^ 
ty, to Dothan; J. W. Payne, from Live Oak, Florida, to Dothan; 
R. D. Blackshear, from Gadsden, Etowah county, to Dothan. 

Moved out of the county — ^J. E. Lee, from Gordon to Waycross, 
Georgia. 

ISxaminations — J. R. Vann, certificate granted; T. J. Kennedy, 
certificate granted. 

Deaths — F. I. Moody, Dothan, pneumonia. 

JACKSON COUNTY MEDICAL SOCIETY— Mobile, 1882. 

OFFICEBS. 

President, J. W. Knowlton; Vice-President, W. C. Maples; Secre- 
tary, J. P. Rorex; Treasurer, J. P. Rorex; Health Officer, J. W. 
Knowlton. Censors — G. W. Foster, W. C. Maples, J. W. Knowl- 
ton, E. R. Smith, T. E. Callan. 

NAMES or MEMBERS WFTH THEIB C0LLE0E8 A.ND POST^ITICXS. 

Blakemore, Andrew Newton, mc univ Tennessee 80, cb 82, Lar- 
kinsviUe. 

Boggess, John Wilson, mc Vanderbilt 92, cb Marshall 93, Woodville. 

Callan, Thomas Edward, mc Alabama 94, cb 94, Scottsboro. 

Foster, George Whitfield, mc univ Nashville 82, cb 82, Stevenson. 

Knowlton, James Wiley, mc univ Vanderbilt 83, cb 83, Paint Rock. 

Maples, William Caswell, mc univ Tennessee 81, cb Madison 81, 
Scottsboro. 

McLendon, William LaFayette, mc Alabama 96, cb 96, Hollywood. 

Rorex, James Polk, mc Alabama 75, cb 82, Scottsboro. 

Sanders, Walter Constantine, mc Memphis Hospital 91, cb Madi- 
son 91, Stevenson. 

Smith, Eugene Robinett, mc univ Vanderbilt 86, cb 89, Dutton.. 
Total, 10. 



ISQ THE MEDICAL AB80CIATI0N OF ALABAMA. 

PHTSICIAirS NOT MBMREBB OF THE 80CIETT. 

AdklnB, Charles WiUiani, mc Louisville 68, cb 84, Langston. 
Bogart, William, mc univ Vanderbilt 1900, cb 1900, Stevenson. 
Boyd, Andrew, mc Phys. and Surg. Baltimore 88, cb 88, Scottsboro. 
Boyd, Hugh, mc Memphis 99, cb 1900, Scottsboro. 
Brewer, Joseph M., mc univ Vanderbilt 82, cb 82, Trenton. 
Oattis, Henry Franklin, ng, cb 82, Holly Tree. 
Orant, Felix, ng, cb 82, Larkins. 

Haralson, Jefferson B., mc Memphis 87, cb DeKalb 88, Langston. 
James, William, mc univ Vanderbilt 82, cb 90, Bolivar. 
Johnson, James Robert, ng, cb DeKalb 82, Kirby's Creek. 
Lee, Elisha L., mc univ Vanderbilt 73, cb 82, Bridgeport 
McCord, John Harvey, ng, cb 82, Section. 
Prince, Jesse Lee, mc Alabama 99, cb 99, Coffey's Store. 
Reid, James R., mc Alabama 93, cb 93, Estills. 
Smith, Barton Brown, Sr., mc Nashville 67, cb 83, Larkinsville. 
Smith, William Barton, ng, cb 82, Aspel. 
Spiller, William Kingston, mc Louisville 74, cb 84, Bridgeport 
Tate, George T., mc univ Vandervilt 96, cb Marshall 96, Wainsville. 
Zurmehley, William, mc univ Vanderbilt 1900, cb 1900, Stevenson. 
Total, 19. 

Moved out of the county — James Ned Buchanan, from Scottsboro 
to Cullman; Emmet K. Moon, from Hollywood to Anniston. 

Examinations — ^William Bogart certificate granted; Eugene R. 
Smith, Jr., certificate granted; William Earl Noel, certificate 
granted; W. R. McRee, certificate refused; Hugh C. McRee, cer- 
tificate refused. 

Deaths — ^T. H. Helton, of pneumonia, Caffey's Store; Oreen 
Pryor McAfee, Lim Rock. 

JEFFERSON COUNTY MEDICAL SOCIETY— Birmingham, 1887. 

OFFICBBS. 

President, W. E. B. Davis; Vice-President, H. L. Martin; Sec- 
retary, E. A. Jones; Treasurer, R. V. Mobley; Health Oflicer, J. 
M. Mason. Censors. — ^E. H. ShoU, C. Wilson, L. G. Woodson, E. 
P. Riggs, A. T. Henley. 

NAMES OF MEMBERS WITH THEIB COLLEGES AND FOST-OFFICES. 

Abemathy, Jones Cadwalader, mc univ Louisville 69, cb Marengo 

78, Birmingham. 
Alexander, Harvard Augustus, mc s of m Kentucky 76, cb Macon 

78, Birmingham. 
Baker. Dicia Houston, mc Women's Memorial Cincinnati 98, cb 99, 

Birmingham. 



THE ROLL OF THE COUNTY 80CIETIEB. 187 

Baady, B. C, mc Montezuma 98, cb Bibb 98, Bessemer. 

Baakston, Richard Coopender, mc univ Tulane 88, cb 96, Birming- 
iiam. 

Barclay, John Wyeth, mc Jefferson 69, cb Madison 78, Birmingham. 

Bamett, Thomas Meriwether, mc nniv Vanderbilt 99, cb Chilton 
99, Birmingham. 

Barrett, Nathaniel Aldridge, mc univ Vanderbilt 86, cb Lauder- 
dale 86, East Lake. 

Berry, Albert Alford, mc univ Virginia 82, cb 85, Birmingham. 

Brown, George Summers, mc Jefferson 86, cb 87, Birmingham. 

Brown, George Washington, mc Atlanta 77, cb 78, Pratt City. 

Brown, Thomas Jefferson, mc univ Vinrinia 85, cb 86, Pratt City. 
Birmingham. 

Brown, Quarles Jemison, mc Alabama 1900, cb Hale 1900, Bir- 
mingham. 

Caffee, Samuel Richardson, mc univ Missouri 81, cb Tuscaloosa 81, 
Avondale. 

Clark, Nathaniel Guido, mc Birmingham 98, cb 98, Ensley. 

Collins, Milton Homer, mc univ Tennessee 84, cb 84, North Bir- 
mingham. 

Compton, Felix Henry, mc univ Vanderbilt 81, cb Madison 97, Bir- 
mingham. 

Copeland, Benjamin Grigsby, mc Jefferson 83, cb Limestone 83, 
Birmingham. 

Coston, Hamilton Ralls, mc univ Washington, Baltimore 72, cb 90, 
Birmingham. 

Cotton, Robert, mc univ Tulane 67, cb 86, Birmingham. 

Coulboume, Joseph Thomas, mc univ Maryland 86, State Board 86, 
Birmingham. 

Crowe, Philip Patterson, mc univ Nashyille 77, cb St Clair 78» 
Brookside. 

Cunningham, Russell McWhorter, mc Bellevue 79, cb 83, Ensley. 

Cunningham, Modie Ezra, mc Birmingham 1900, cb 1900, Ensley. 

Dabney, John Davis, mc univ Washington, Baltimore 72, cb 90, 
Birmingham. 

Davis, John Daniel Sinkler. mc Georgia 79, cb St. Clair 79. Bir- 
mingham. 

Davis, Wm. Ellas Browlee, mc Bellevue 89, cb 84, Birmingham. 

Dedman, James Edwin, mc univ Tennessee 91, cb 98, Birmingham. 

Donald, T. C, mc Alabama 99, 

Drennen, Charles, mc Alabama 72, cb Blount 78, Birmingham. 

Drennen, David Edward, mc Alabama 94, cb 94, Birmingham. 

Due, Malvern Nicholas, mc Phys. and Surg. New York 88, cb Mont- 
gomery 88, Birmingham. 



188 THE MEDICAL ASSOCIATION OF ALABAMA. 

Duncan, Joseph Johnston, mc univ Louisville 86, State Board 86^ 
Birmingham. 

Dunlap, Perry Gabriel, mc univ Vanderbilt 81, cb St Clair 81, Adger. 

Edwards, Joseph Henry, mc Birmingham 97, cb 97, Wylam. 

Finch, J. H., mc Birmingham — , cb — , Avondale. 

Fox, Care Alexander, mc univ Tulane 1900, cb 1900, Birmingham. 

Fox, Bertram Arthur, mc Birmingham 96, cb 96, Birmingham. 

Gibson, Jefferson Demetrius, mc Alabama 87, cb Tuscaloosa 87, 
Birmingham. 

Glass, Edward Taylor, mc univ Vanderbilt 90, cb 90, Birmingham. 

Harkness, Robert Baskin, mc univ Tulane 97, cb Tuscaloosa 97, 
New Castle. 

Hamrick, Robert Hampton, mc Atlanta 95, cb Blount 96, Pratt City. 

Harwell, James Thomas, mc Atlanta Southern 83, cb Cullman 83, 
Ishkooda. 

Hawkins, Richard Nathaniel, mc Miama, Ohio 67, cb Shelby 87,. 
Birmingham. 

Heacock, Joseph Davis, mc univ Tulane 92, cb Talladega 92, Wood- 
lawn. 

Heard, George Phillip, mc Phys. and Surg. New York 94, cb 1900, 
Birmingham. 

Heflin, Howard Towles, mc univ Maryland 93, cb Clay 94, Bir- 
mingham. 

Heflin, Wyatt, mc Jefferson 84, cb Randolph 86, Birmingham. 

Hendon, W. T., mc , cb — , Ensley. 

Henley, Albert Thomas, mc univ New York 69, cb Hale 78, Bir- 
mingham. 

Hix, Nicholas Flood, mc univ Virginia 1900, cb 1900, Gate City. 

Hogan, George Archibald, mc Birmingham 96, cb 96, Johns. 

Howard, John Wesley, mc Atlanta 91, cb Shelby 91, Irondale. 

Jenkins, Luckie Andrew, mc Alabama 89, cb Wilcox 89, Cardiff. 

Jemigan, Charles Henry, mc Jefferson 65, cb Bullock 80, Birming- 
ham. 

Johnston, Hardee, mc univ Virginia 95, cb 96, Birmingham. 

Jones, Capers Capehart, mc univ m of s Philadelphia 70, cb Wil- 
cox 79, East Lake. 

Jones, Devotie Dennis, mc univ Maryland 72, cb Lowndes 72, Wood- 
lawn. 

Jones, Edgar Allen, mc Birmingham 98, cb 98, Birmingham. 

Jones, Robert Arthur, mc Louisville 86, cb 86, Birmingham. 

Jordon, William Mudd, mc Phys. and Surg. New York 95, cb 96, 
Birmingham. 

Killough, James Monroe, mc s of m Kentucky 87, cb 87, Huffman. 



THE ROLL OF THE COUNTY SOCIETIES. 189 

Klebs, Theodore Alexander, mc Tulane 76, cb 87, Birmingham. 

Lacey, Edward Parish, mc univ Vanderbllt 83, cb Shelby 83, Besse- 
mer. 

Ledbetter, Samuel Leonidas, mc Louisville 79, cb 79, Birmingham. 

LeGrand, John Clarke, mc Atlanta 80, cb 81, Birmingham. 

Lewis, Francis Porcher, mc South Carolina 76, cb 80, Coalburg. 

Luckie, James Buckner, mc Pennsylvania 66, cb 78, Birmingham. 

Lupton, Frank Allemong, mc Johns Hopkins 99, cb 1900, Birming- 
ham. 

Martin, Henry Lewis, mc univ Vanderbllt 81, cb Madison 81, Avon- 
dale. 

Mason, James Monroe, Jr., mc Tulane 97, cb 99, Birmingham. 

McAdory, Wellington Prude, mc univ Virginia 97, cb 99, Birming- 
ham. 

McCarty. James Henry, mc Atlanta 80, cb 83, Birmingham. 

Mobley, Robert Vernon, mc Alabama 89, cb Clarke 89, Birmingham. 

Moore, John Austin, mc Phys. and Surg. Baltimore 86, cb Blount 
86, Birmingham. 

Morris, Edward Watts, mc univ Virginia 86, cb 87, Birmingham. 

Odom, J. J., , cb , Littleton. 

Parke, Thomas Duke, mc univ New York 79, cb Dallas 84, Bir- 
mingham. 

Payne, John, mc Jefferson 86, cb Shelby 86, Millman. 

Peters, Thomas Marion, mc Alabama 90, cb Fayette 90, BirminghanL 

Peters, Urban Joseph Whitehead, univ Pennsylvania 98, cb 1900, 
Birmingham. 

Pittman, John Greene, mc Phys. and Surg. New York, 1900, cb 1900, 
Birmingham. 

Pressley, Henry Erskine, mc univ New York 99, cb 99, Birmingham. 

Prince, Francis Marion, mc Jefferson 49, cb 78, Bessemer. 

Ransom, William Walter, mc univ Vanderbllt 88, cb 88, Birmingham. 

Rlggs, Edward Powell, mc Phys. and Surg. Baltimore 81, cb Dallas 
81, Birmingham. 

Rittenberry, Baxter, mc Birmingham 99, cb 99, Birmingham. 

Robbins, Jesse Elbert, mc Atlanta 86, cb 86, Brookslde. 

Robertson Thaddeus Lindley, mc Jefferson 61, cb Calhoun 81, Bir- 
mingham. 

Robinson, Elisha Milton, mc univ Tulane 86, cb Blount 86, Bir- 
mingham. 

Robinson, Thomas Franklin,m c univ Nashville 80, cb Blount 80, 
Bessemer. 

Rogers, Mack, mc Alabama 89, cb Conecuh 89, Birmingham. 

Rosser, Henry Nollner, mc Atlanta 69, cb Dallas 79, Birmingham. 



Igg THE MEDICAL ASSOCIATION OF ALABAMA. 

Duncan, Joseph Johnston, mc univ Louisville 86, State Board 86^ 
Birmingham. 

Dunlap, Perry Qabrlel, mc unlv Vanderbilt 81, cb St Clair 81, Adger. 

Edwards, Joseph Henry, mc Birmingham 97, cb 97, Wylam. 

Finch, J. H., mc Birmingham — , cb — , Avondale. 

Fox, Care Alexander, mc univ Tulane 1900, cb 1900, Birmingham. 

Fox, Bertram Arthur, mc Birmingham 96, cb 96, Birmingham. 

Gibson, Jefferson Demetrius, mc Alabama 87, cb Tuscaloosa 87» 
Birmingham. 

Olass, Edward Taylor, mc univ Vanderbilt 90, cb 90, Birmingham. 

Harkness, Robert Baskln, mc univ Tulane 97, cb Tuscaloosa 97, 
New Castle. 

Hamrick, Robert Hampton, mc Atlanta 95, cb Blount 96, Pratt City. 

Harwell, James Thomas, mc Atlanta Southern 83, cb Cullman 83, 
Ishkooda. 

Hawkins, Richard Nathaniel, mc Miama, Ohio 67, cb Shelby 87,. 
Birmingham. 

Heacock, Joseph Davis, mc univ Tulane 92, cb Talladega 92, Wood- 
lawn. 

Heard, George Phillip, mc Phys. and Surg. New York 94, cb 1900,. 
Birmingham. 

Heflin, Howard Towles, mc univ Maryland 93, cb Clay 94, Bir- 
mingham. 

Heflin, Wyatt, mc Jefferson 84, cb Randolph 85, Birmingham. 

Hendon, W. T., mc , cb — , Ensley. 

Henley, Albert Thomas, mc univ New York 69, cb Hale 78, Bir- 
mingham. 

Hix, Nicholas Flood, mc univ Virginia 1900, cb 1900, Gate City. 

Hogan, George Archibald, mc Birmingham 96, cb 96, Johns. 

Howard, John Wesley, mc Atlanta 91, cb Shelby 91, Irondale. 

Jenkins, Luckie Andrew, mc Alabama 89, cb Wilcox 89, Cardiff. 

Jemigan, Charles Henry, mc JefTerson 55, cb Bullock 80, Birming- 
ham. 

Johnston, Hardee, mc univ Virginia 95, cb 96, Birmingham. 

Jones, Capers Capehart, mc univ m of s Philadelphia 70, cb Wil- 
cox 79, East Lake. 

Jones, Devotie Dennis, mc univ Maryland 72, cb Lowndes 72, Wood- 
lawn. 

Jones, Edgar Allen, mc Birmingham 98, cb 98, Birmingham. 

Jones, Robert Arthur, mc Louisville 86, cb 86, Birmingham. 

Jordon, William Mudd, mc Phys. and Surg. New York 95, cb 95, 
Birmingham. 

KiUough, James Monroe, mc s of m Kentucky 87, cb 87, Huffman. 



THE ROLL OF THE COUNTY SOCIETIES, 189 

Klebs, Theodore Alexander, mc Tulane 76, cb 87, Birmingham. 

Lacey, Edward Parish, mc unlv Vanderbllt 83, cb Shelby 83, Besse- 
mer. 

Ledbetter, Samuel Leonldas, mc Loulsyllle 79, cb 79, Birmingham, 

LeGrand, John Clarke, mc Atlanta 80, cb 81, Birmingham. 

Lewis, Francis Porcher, mc South Carolina 76, cb 80, Coalburg. 

Luckle, James Buckner, mc Pennsylyanla 65, cb 78, Birmingham. 

Lupton, Frank Allemong, mc Johns Hopkins 99, cb 1900, Birming- 
ham. 

Martin, Henry Lewis, mc unlv Vanderbllt 81, cb Madison 81, Avon- 
dale. 

Mason, James Monroe, Jr., mc Tulane 97, cb 99, Birmingham. 

McAdory, Wellington Prude, mc unlv Virginia 97, cb 99, Birming- 
ham. 

McCarty, James Henry, mc Atlanta 80, cb 83, Birmingham. 

Mobley, Robert Vernon, mc Alabama 89, cb Clarke 89, Birmingham. 

Moore, John Austin, mc Phys. and Surg. Baltimore 85, cb Blount 
85, Birmingham. 

Morris, Edward Watts, mc unlv Virginia 85, cb 87, Birmingham. 

Odom, J. J., , cb , Littleton. 

Parke, Thomas Duke, mc unlv New York 79, cb Dallas 84, Bir- 
mingham. 

Payne, John, mc Jefferson 86, cb Shelby 86, MlUman. 

Peters, Thomas Marlon, mc Alabama 90, cb Fayette 90, BlrmlnghanL 

Peters, Urban Joseph Whitehead, unlv Pennsylvania 98, cb 1900, 
Birmingham. 

Plttman, John Greene, mc Phys. and Surg. New York, 1900, cb 1900, 
Birmingham. 

Pressley, Henry Ersklne, mc unlv New York 99, cb 99, Birmingham. 

Prince, Francis Marlon, mc Jefferson 49, cb 78, Bessemer. 

Ransom, William Walter, mc unlv Vanderbllt 88, cb 88, Birmingham. 

Rlsgs, Edward Powell, mc Phys. and Surg. Baltimore 81, cb Dallas 
81, Birmingham. 

Rlttenberry, Baxter, mc Birmingham 99, cb 99, Birmingham. 

Robblns, Jesse Elbert, mc Atlanta 86, cb 86, Brookslde. 

Robertson Thaddeus Llndley, mc Jefferson 61, cb Calhoun 81, Bir- 
mingham. 

Robinson, BUsha Milton, mc unlv Tulane 85, cb Blount 86, Bir- 
mingham. 

Boblnson, Thomas Franklln,m c unlv Nashville 80, cb Blount 80, 
Bessemer. 

Rogers, Mack, mc Alabama 89, cb Conecuh 89, Birmingham. 

Rosser, Henry NoUner, mc Atlanta 69, cb Dallas 79, Birmingham. 



190 ^^^ MEDICAL ASSOCIATION OF ALABAMA. 

Rountree, Walter Scott, mc Birmlngbam 1900, cb Morgan 1900^ 
Wylam. 

Sanders, A. J., , cb — , Leeds. 

Sellers, Ira Jackson, mc univ Vanderbilt 97, cb 97, Avondale. 

Sexton, Charles Richard, mc univ Tulane 75, cb Tuscaloosa 78^ 
Birmingham. 

Shoemaker, Worcester Ney, mc Columbus 78, cb 81, Birmingham. 

Sholl, Edward Henry, mc Pennsylvania 56, cb Sumter 78, Bir- 
mingham. 

Steves, Henry Fordyce, ng State Board 87, Gate City. 

Stubbs, George Hamilton, mc Atlanta Southern 95, cb 97, Bir- 
mingham. 

Talley, Dyer Findley, mc univ Tulane 92, cb 92, Birmingham. 

Torrance, Gaston, univ Virginia 97, cb 1900, Birmingham. 

Waller, George D., , cb , Bessemer. 

Walton, Frank, mc univ Vanderbilt 99, State Board 99, Blossburg. 

Ward, Henry Silas, mc univ Nashville 98, cb Blount 99, Birmingham. 

Warwick, Andrew Sitlington, mc univ New York 92, cb 1901, Bir- 
mingham. 

Wetherbee, Joseph Bobbins, mc Jefferson 1900, cb 1900, Thomas. 

Whaley, Lewis, mc Atlanta 73, cb Blount 78, Birmingham. 

Whelan, Charles, mc Alabama 96, cb 96, Birmingham. 

Wikle, Luther Lafayette, mc univ Tennessee 88, cb 88, Village 
Springs. 

Wilder, William Hinton, mc univ New York 91, cb 91, Birmingham. 

Wilson, Cunningham, mc univ Pennslyvania 84, cb 84, Birmingham. 

Wood, Winston Cass, mc Atlanta 81, cb 81, Bessemer. 

Woodson, Lewis Greene, mc univ Maryland 86, cb 88, Birmingham. 

Wyman, Benjamin Leonidas, mc univ New York 79, cb Tuscaloosa 
82, Birmingham. 

Worcester, John Locke, mc Birmingham 1900,. cb 1900, Birmingham. 

Yates, Carlyle Keyser, mc Baltimore 1900, cb Dallas 1900, Bir- 
mingham. 
Total. 118. 

PHYSICIANS NOT MEMBERS OF THE SOCISTT. 

Acton, William Henser, mc univ Vanderbilt 88, cb Lauderdale 88, 

Leeds. 
Auzford, F. O., mc Alabama 95, cb — , Cardiff. 
Ball, John Calhoun, mc Atlanta 59, cb Calhoun 87, Avondale. 
Ballard, Asa Nathaniel, mc Pulte (Homeopathic) 76, cb DeKalh« 

86, Birmingham. 
Black, W. F.. mc , cb — , Sayreton. 



THE ROLL OF THE COUNTY SOCIETIES. 191 

Blanks. John Harrison, mc uniy Tennessee 91 State Board 98, 
Birmingham. 

Berry, James Crawford, mc South Carolina 95, cb 96, Oxmoor. 

Benton, John M., mc uniy Maryland 90, cb 97, Birmingham. 

Brown, Arthur McKinnon (coL), mc uniy Michigan 91, cb 91, Bir- 
mingham. 

Bumum, Henry Clay, mc Phys. and Surg. Baltimore 92, cb Blount 
92. Chalky ille. 

Byars, Henry Hayden, mc s of m Kentucky 92, cb Perry 92, War- 
rior. 

Carter, James Watson, mc uniy Nashyille 74, cb Limestone 78» 
Bessemer. 

Casey, Edgeworth Stephens, mc Birmingham 1900, cb 1900, Bir- 
mingham. 

Chamblee, Zachariah Britton, mc Birmingham 1900, cb 1900, North 
Birmingham. 

Chlsolm, R. P., mc Alabama 99, cb — , Bessemer. 

Clapp, Wm. Wesley, mc Cleyeland (Homeopathic) 90, cb DeKalb 
90, Birmingham. 

Clajrton, Benjamin Lawrence, mc uniy Virginia 82, cb St Clair 82, 
Ayers. 

Clifton, , cb , Bessemer. 

Cocciola, Luigi, mc Naples, Italy 83, cb Cullman 1900, Birmingham. 

Collins, James Alexander, mc uniy LouisyiUe 91, cb Cullman 91, 
Warrior. 

Cooper, W. D., , cb — , Birmingham. 

Cross, Samuel Mardis, mc Georgia 50, cb 78, Woodlawn. 

Cross, Thos. Winston, mc uniy Nashyille 87, cb 87, Bessemer. 

Dayidson, Jas. Francis, mc Alabama 87, cb 87, Birmingham. 

Dayis, Frederick Eustis, mc Birmingham 99, cb Shelby 99, Blossburg. 

Douglass, A. O., mc , cb — , Birmingham. 

Dozier, Byron T., mc Barnes (St Louis) 97, cb Elmore 1900, Bir- 
mingham. 

Dozier Oliyer Thomas, mc Atlanta 74, cb 97, Birmingham. 

Edmonson, E. L., mc , cb — , Woodlawn. 

Sidmonson, J. S., mc , cb — , Woodlawn. 

Edwards, Robert Smith, mc Atlanta 71, cb 78, TrussyiUe. 

Ellis, George Washington, ng, cb 78, Morris. 

Elsberry, John Pasme, mc uniy Virginia 60, cb Montgomery 84, 
Powderly. 

Farley, A. J., mc , cb — , HiUman. 

Fields, E. T., mc , cb — , E3nsley. 

Finley, W. M., mc , cb — , Piatt 



192 THE MEDICAL ASSOCIATION OF ALABAMA. 

Goin, John Burt (col.) mc Meharry 90, cb 90» Birmingham. 

Green, Robert Smith, mc Atlanta 60, cb 78, Greene's Station. 

Hancock, James Francis, mc Louisville 88, cb Walker 88, Toadvlne. 

Hardin, B. B., , cb — , Woodward. 

Hausman, Frank, mc Alabama 93, cb Tuscaloosa 93, Warrior. 

Hawkins, Elijah Alexis, mc Atlanta Southern 88, cb Walker 89, 
Partridge. 

Hayes, Wm. Isaac, mc Atlanta Southern 85, cb Walker — , Powderly. 

Heddleston, James L., mc South Carolina 55, cb Hale 87, Woodlawn. 

Hickman, C. M., , cb — , Warrior. 

Hill, Chas. Lowery, mc uniy Tennessee 88, cb 88, Elliott. 

HoUoway, Young Edwin, mc Miama Ohio 72, cb Cullman 85, Bir- 
mingham. 

Hood, W. A., , cb — , Clough. 

Huey, J. Fred mc , cb — , Blossburg. 

Hundley, J. T. (col.), mc , cb — , Birmingham. 

Jones, John Columbus, mc Tulane 86, cb 88, Johns. 

Kinnette, Jackson Flavins, mc Georgia Eclectic 92, cb Shelby 92, 
Brighton. 

Knight, J. B., mc , cb — , Ezra. 

Lathem, Luther Middleton, mc Alabama 92, cb Bibb 92, Ensley. 

Lathem, Sinclair Nicholas, mc Birmingham 97, cb St. Clair 97, Bir- 
mingham. 

Lewis, G. R., mc , cb — , Bessmer. 

Lewis, James Marshall, mc univ Vanderbllt 87, cb 88, Birmingham. 

Love, William Jones, mc Alabama 93, cb Morgan 93, Mt. Pinson. 

Mason, Ulyses G. (col.), mc Meharry 95, cb 95, Birmingham. 

May, W. L., mc , cb — , Sandusky. 

May, Frank H., mc univ ot South 99, cb Marion 99, Birmingham. 

McClain, Fred Augustus, mc Louisville 94, cb 94, Wylam. 

McGlathery, Fountain S., mc univ Vanderbllt 82, cb Morgan 82, 
Woodlawn. 

Means, George Evins, mc univ Tulane 89, cb 94, Bessemer. 

Miller, James M., mc Alabama 84, cb Walker 88, Blossburg. 

Mitchell, R. L., mc , cb — , Laban. 

Miles, Wm. Cowden, mc Birmingham 99, cb Limestone 1900, Dale. 

Naff, J. M., mc , cb — , Republic. 

Norton, H. F., mc , cb — , Leeds. 

Gates, D. D., mc , cb — , Merkel. 

Oliver, Wm. Marmaduke, mc Alabama 72, cb 78, Jonesboro. 

Owen, William Marmaduke, (Old Law), cb 87, Jonesboro. 

Pope, C. M., mc , cb — , Henry Ellen. 

Ragsdale, Milton C, mc Georgia 78, cb 78, McCalla. 



TBB ROLL OF THE COUNTY B00IBTIB8. 193 

Roberta, Martin, Old Law ng, cb 80, Warrior. 

Robertaon, Jasper Bennett, mc unlv Vanderbilt 69, cb St. Clair 78, 

Woodlawn. 
Roper, Wm. Blllott, mc nniy Louiayille 88, cb Shelby 88, Belle 

Sumter. 
Rosamond, Wm. LuciuB, mc 8 of m Kentucky 91, cb Walker 91, 

Bnsley. 
Rnflsell, Ralph Morgan, mc Bellevue 88, cb Btowah 89, Birmingham. 
Scott, Joseph Newton, mc Alabama 87, cb 87, Birmingham. 
Scott, Andrew L., mc Barnes (St. Louis) 96, cb 96, Birmingham. 
Beay, James B., mc Bellevue Hospital 99, cb Lamar — , Pratt City. 

Shaw, B. T., mc , cb — , Blossburg. 

Sbeppard, Louis Watson, mc Phys. and Surg. Baltimore 86, cb St. 

Clair 89, Bessemer. 
Sibley, B. D., mc Birmingham 98, cb — , Warrior. 
Smith, Robert Lee, mc Louisrille 91, cb — , Toadvine. 
Spencer, Lucian Allen, mc Miami (O.) 85, cb 85, Bessemer. 
Stagg, John Bell, mc univ Vanderbilt 85, cb Walker 85, Pratt City. 
Statum, Job Nelson, mc Atlanta Southern 88, cb 88, Blossburg. 
Trainer, Bdward W., ng, ^, cb Marshall 86, Pratt City. 
Tubbs, James, mc Memphis 94, cb Walker 94, Bessemer. 

Vines, J. B., mc , cb — , Short Creek. 

Waldrop, R. W., mc LouisTille 96, cb 97, Bessemer. 
Waldrop, William, mc Memphis 99, State Board 99, Woodward. 
Washington, S. S. H. (col.), mc univ Howard 86, cb 87, Birmingham. 
Whissenant, Lewis D., ng, cb 78, Morris. 

Wilkerson, Geo. H., (col.), mc Meharry 97, cb 97, Birmingham. 
Williams, Jack W., mc Phys. and Surg. 82, cb Russell — , Bir- 
mingham. 
Winters, Joseph Schofleld, mc Louisville 90, cb 90, Bessemer. 
Wooley, Albert Spann, mc Philadelphia 61, cb Dallas 84, Bii^ 

mingham. 

Total, 100. 

Moved into the county — T. M. Peters, from Fayette county to 
Birmingham; O. M. Milner, from Bibb county to Birmingham; 
F. H. May, from Madison county to Birmingham. 

Moved out of the county — ^W. T. Berry, from Birmingham to 
New York City; J. P. Hawkins, from Avondale to St. Clair county; 
J. W. Hirst, from Thomas to Philadelphia, Pa.; W. C. Williams, 
from North Birmingham to Shelby county; John W. Gamble, from 
Birmingham to Wetumpka; Samuel Perry, from Birmingham to 
Perry county; W. F. Oliver, from Woodlawn to » 

13 



194 THE MEDICAL AB80CIATI0N OF ALABAMA. 

Examinations — ^Frank A. Lupton, mc Johns Hopkins 99, certifi- 
cate granted ;Edgeworth Stephens Casey, mc Birmingham 1900, 
certificate granted; John Locke Worcester, mc Birmingham 1900, 
certificate granted; Carl Alexander Fox, mc Tulane 1900, certifi- 
cate granted; Joseph Robblns Wetherbee, mc Jefferson 1900, cer- 
tificate granted; Harry Graham Sellers, mc Vanderbilt 1900, cer- 
tificate refused; Zachariah Brltton Chamblee, Birmingham 1900, 
certificate granted; Joseph Jefferson McBlroy, mc Atlanta Med. 
98, certificate refused; Modie Ezra Cunningham, mc Birmingham 
1900, certificate granted; Urban Joseph Whitehead Peters, mc unir 
Pennsylvania 98, certificate granted; John Oreene Pittman, mc 
Phys. and Surg. New York 1900, certificate granted; Nicholas Flood 
Hix, mc univ Virginia 1900, certificate granted; Gaston Torrance, 
mc univ Virginia 97, certificate granted; George Philip Heard, mc 
Phys. and Surg. New York 94, certificate granted; Charles Pres- 
ton Eichelberger, mc univ Virginia 96, certificate refused; Hamil- 
ton Ralls Coston, mc Vanderbilt 89, certificate granted; Andrew 
Sitlington Warwick, mc univ New York 92, centificate granted; 
Rufus Crockett McGahey, mc Vanderbilt 78, certificate refused. 

Deaths — ^Jno. G. Griggs, Oct. 21, 1900, apoplexy, Birmingham; 
George Clarence Chapman, killed by tornado, March 25, 1901, Bir- 
mingham. 

LAMAR COUNTY MEDICAL SOCIETY— Birmingham, 1877. 

OFFICEBS. 

President, B. E. Turner; Vice-President, W. L. Morton; Secre- 
tary, J. C. Buckelew; Treasurer, J. C. Buckelew; Health Officer, 
W. F. Elliott. Censors. — ^R. J. Redden, G. C. Burns, J. C. Bucke- 
lew, T. B. Woods. 

NAMES OF MEMBERS WITH THEIB COLLEGES AND POST-OFFICES. 

Buckelew, Judge Crayton, mc univ Grant 98, cb 98, Sulligent. 

Bums, George Caruthers, mc 111. Health Univ. 96, cb 78, Vernon. 

Elliott, William Farris, mc univ Louisville 67, cb 77, Malloy. 

Hollis, Daniel Dixie, mc Phys. and Surg. Baltimore 84, cb 84, Sul- 
ligent. 

Kennedy, John Oscar, mc Alabama 82, cb 82, Kennedy. 

Morton, William Locke, mc univ Louisiana 74» cb 77, Vernon. 

Redden, Robert James, mc Baltimore 77, cb 77, Sulligent 

Turner, Berry Eddley, mc Memphis Hospital 97, cb 97, Richard. 

Woods, Thomas Bailey, mc univ Louisville 73, cb Fayette — , Bell. 
Total, 9. 



THE ROLL OF THE COUNTY SOCIETIES. I95 

PHTBICIANS HOT mnfHPB OF THB BOdETT. 

Armfltrong, Warren, ng, cb 80, Detroit 

BarksdalOp James Ira, mc Vanderbilt 72, cb Tuscaloosa 86, Fembank. 

Barrentine, Kelley Jason, mc Phys. and Surg. St. Louis 99, cb 1900, 
Millport. 

Black, William Anderson, mc Memphis Hospital 92, cb Fayette 96, 
Cawoon. 

Blakeney, Lewis Columbus, mc Alabama 73, cb 77, Millport. 

Box, Daniel William, mc Alabama 85, cb 86, Vernon. 

Bronyan, James A., mc univ Louisville 92, cb 92, KingsviUe. 

Btickelew, Ansel Milbum, mc univ Louisville 70, cb Calhoun 86, 
Sulligent 

Collier, Scott, ng, cb 77, Pharos. 

Collins, Francis Alexander, mc Memphis Hospital 92, cb 92, Blow- 
horn. 

Collins, George Jackson, mc Alabama 74, cb Fayette 84, Kennedy. 

Horton, John Barkley, mc Memphis Hospital 95, cb 96, Kennedy. 

Kennedy, William Henderson, mc univ Nashville 57, cb 77, Kennedy. 

Owens, A C, (illegal), Crews. 

Patton, James Luther, mc Memphis Hospital 1900, cb Marion 1900, 
Detroit. 

Vaughn, George Washington, mc Alabama — , cb Marion 88, Wotford. 
Total, 16. 

Moved into the county — J. L. Patton, from liarion county to 
Detroit. 

Moved out of the county — Dick Cameron Morton, from Vernon to 
New Decatur, Morgan county. 

Examinations — George Marvin Milner, mc Birmingham 1900, 
certificate granted; Arlando Berry Collins, Vanderbilt mc 1900, 
certificate granted. 

LAUDERDALE COUNTY MEDICAL SOCIETY— Tuscaloosa, 1887. 

OFFICBBS. 

President— -W. M. Price; Vice-President, L. F. Duckett; Secre- 
tary, J. M. Peerson. Censors — C. M. Watson, C. A. Crow, L. W. 
Arnold, W. J. Kemochan, J. A. Pate. 

NAMES OF MEMBERS WITH THEIB COLLEGES AND FOBT-OmCES. 

Arnold, Leonard Warring, mc Ohio 77, cb 87, Florence. 
Belew, John Columbus, ng, cb 90, Rogersville. 
Boyd, P. S., (Homeopath), cb — , Florence. 

Carroll, G. W., mc , cb — , Gravelly Springs. 

Crow, Calvin Augustus, mc Jefterson 64, cb 78, Florence, 



X96 ^^^ MEDICAL ASSOCIATION OF ALABAMA, 

Duckett, John D., mc uniy Vanderbilt 99, cb — , Florence. 
Duckett, Levi Fowler, Jr., mc unly Tennessee 91, cb 94, Cloverdale. 
Kennedy, Hiram Raleigh, mc univ Loulsyille 79, cb 81, Green Hill. 
Kemochan, William Jones, mc uniy Vanderbilt 79, cb 88, Florence. 
Moody, Henry Altamont, mc uniy Loulsyille 65, cb 87, Bailey 

Springs. 
Pate, Jesse Americus, mc uniy Loulsyille 70, cb 87, Rogersyille. 
Paulk, Samuel D., mc uniy Vanderbilt 86, cb — , Florence. 
Peerson, James M., mc uniy Vanderbilt 91, cb 91, Florence. 

Pitt, P. T., mc , cb — , Florence. 

Powers, Alexander Hamilton, mc Loulsyille 71, cb — , Florence. 
Price, William Mason, mc uniy Nashyille 64, cb 87, Florence. 
Price, Perry Isaac, mc uniy Vanderbilt 86, cb 87, Florence. 
Scott, George Barbiere, mc Jefferson 90, cb 90, Florence. 
Watson, Charles McAlpine, mc uniy Louisiana 81, cb Greene 81, 

Florence. 

Total, 19. 

PHT8ICIAN8 NOT MEMBERS OF THE SOGIErT. 

Bramlet, William M., mc uniy Nashyille 60, cb 87, Florence. 
Henderson, A. H., mc uniy Nashyille 76, cb 87, Florence. 

Lee, J. W., mc , cb — , Waterloo. 

Morris, J. C, mc , cb — , Threet 

Total, 4. 

Efacaminations — ^Henry Lee Stutts, John Douglass, C. B. Diebold, B. 
J. Duckett, certificates granted. 

Death — ^William Bpps Hardaway, Florence. 
LAWRENCE COUNTY MEDICAL SOCIBTY—Blrmingham, 1877. 

OFTIOEBS. 

President, C. S. Chenault; Vice-President, E. T. Simms; Secre- 
tary, Wm. J. McMahon; Treasurer, Wm. J. McMahon; Health Of- 
ficer, Wm. J. McMahon. Censors— H. B. Burkett, J. R. Howell, 
L. W. Houston, I. W. Fennell, F. D. Gibson. 

NAMES OF MEMBEE8 WITH THEIB COLLEGES AND POST-OFFICES. 

Burkett, Henry Bascomb, mc Phys. and Surg. New York 78, cb 78, 

HUlsboro. 
Chenault, Charles Sidney, mc Birmingham 97, cb 97, Mt. Hope. 
Edward, John Wilson, mc Loulsyille 69, cb 79, Courtland. 
Etheredge, Benjamin Franklin, mc Memphis Hospital 86, cb 86, 

Town Creek. 

Fennell, Isham Watkins, mc Nashville 67, cb Limestone 78, Court- 
land. 



TBB ROLL OF THE COUNTY BOOIETIEB. 197 

Gibson, Frank Demetrius, mc univ Nashville 90, cb 92, Moulton. 

Greer, William Henry, mc Qrant Chattanooga Tenn. 1900, ob Cl«h 
bume 1900, Courtland. 

Houston Leonidas Walton, mc uniy Nashville 77, cb 78, Town Creek. 

Howell, John Robert, mc Memphis Hospital 88, cb 94, Hatton. 

Irvrin, Thomas Howard, mc Vanderbilt 1900, cb 1900, Moulton. 

Masterson, John Thomas, mc m and s Pennsylvania cb 78, Moulton. 

McDonald, John Robert, mc univ Nashville 67, cb Madison 78, 
Courtland. 

McMahon, Wm. Jack, mc Long Island 60, New Orleans 61, cb Madi- 
son 78, Courtland. 

Simms, Edgar Thomas, mc Pennsylvania 69, cb 78, HiUsborro. 
Total, 14. 

Moved into the county — William H. Greer, from EdwardsviUe, 
Cleburne county, to Courtland. 

Moved out of the county-^James R. Roberson, from Mt. Hope to 

; James T. Pitt, from Hlllsboro to Florence, Lauderdale 

county. 

Examinations — Thomas H. Irwin, mc Vanderbilt 1900, certifi- 
cate granted. 

LEE COUNTY MEDICAL SOClETT^Huntsville, 1880. 

OmOKBS. 

President, A. H. Read; Vice-President, J. M. Watkins; Secretary, 
I. N. Stowe; Treasurer, I. N. Stowe; Health Officer, W. <R. Wee- 
don. Censors — ^A. H. Read, A. B. Bennett, J. Q. Palmer, I. N. 
Stowe, W. B. Watkins. 

NAMES OF MBMBSBS WITH THEIB COLLEGES AND P08T-0PFICB8. 

Bennett, Abijah B., mc Phys. and Surg. Baltimore 81, cb 81, Opelika. 
Bedell, Robert Bruce, mc South Carolina 81, cb 81, Auburn. 
Drake, John Hodges, Sr., mc Atlanta 67, cb 81, Auburn. 
Palmer, Jesse Gary, mc Phys. and Surg. Baltimore 84, cb 84, Opelika. 
Read, Andrew Hamil, mc Georgia 68, cb 81, Opelika. 

Steadham, O. M., mc , cb — , Auburn. 

Stowe, Isaac Noel, mc Georgia Eclectic 98, cb 95, Opelika. 
Watkins, John Marlon, mc Tulane 71, cb Tallapoosa 87, Opelika. 
Watkins, Warren B., mc Bellevue Hospital 97, cb 98, Opelika. 
Watkins, James Preston, mc Phys. and Surg. Baltimore 97, cb 97, 

Opelika. 
Weedon, Walter R., mc Kentucky S of M 94, cb Barbour 94, Opelika. 
Wheelis, James Raleigh, mc Atlanta — , cb — , Bullock. 

Total, 12. 



198 ^^^ MEt)lCAL A880CtAfI02f OF ALABAMA. 

PHT8I0IANS 2T0T MKMBBB8 OF THB 80GIBTT. 

Floyd, ABhly, mc uniy Louisiana 89, cb 95, Phoenix City. 
Foreman, Arthur Levi, mc Jefferson 69, cb 81, Auburn. 
Shelton, Menzo Davis, mc univ Nashville 69, cb 81, Salem. 
Yarbrough, C. S., mc Atlanta 97, cb 97, Beulah. 
Total, 4. 

Moved into the county — James J. Peterson; R. D. Howe, from 
Elmore county, to . 

Moved out of the county — ^Joseph R. Harmer, from Opellka to 

Army Post, S. C; Jas. J. Peterson, from , to Mobile; Jos. 

M. Love, from to LaFayette, Chambers county. 

Death — Charles B. McCoy, Opelika. 
LIMBSTONE COUNTY MEDICAL SOCIETY— Birmingham, 1877. 

OFnOBBS. 

President, Theo. Westmoreland; Vice President, ; Sec- 
retary, T. C. Jones; Treasurer, O. A. Williams; Health Officer, 
N. D. Richardson. Censors — ^W. J. Hagan, Theo. Westmoreland, 
T. C. Jones. 

NAMES OF MEMBBBS WITH THBIB COLLBOBB AJSTD POST-OFFICES. 

Crutcher, John Sims, mc univ Vanderbilt 89, cb 89, Athens. 

Dupree, William James, mc univ Vanderbilt 76, cb 79, Westmore- 
land. 

Hagan, William James, mc Jefferson 84, cb 84, Athens. 

Hoffman, John Crittenden, mc Jefferson 58, cb 78, Athens. 

Jones, Thomas Crittenden, mc univ Louisville 76, cb Chambers 88, 
Athens. 

Moore, Elisha Dixon, (Old Law) 67, cb 78, Athens. 

Pettus, Benton Sanders, mc univ Vanderbilt 92, cb 92, Pettusville. 

Pettus, Joseph Albert, mc univ Nashville 67, cb 77, Elkmont 

Rankin, James Coffield Mitchell, mc univ Nashville 58, cb 78, Bellt 
Mina. 

Richardson, N. D.,mc Vanderbilt 91, cb 1900, Athens. 

Westmoreland, Theophilus, mc univ Vanderbilt 56, cb 79, Athens. 

Wilkinson, Milton Roll, mc univ Nashville 68, cb 78, Westmoreland. 

Williams, George Allen, mc univ Nashville 80, cb 81, Elkmont 

Wilson, Felix Orundy, mc univ Nashville 65, cb 76, Elkmont. 

York, Seaborn Edward, mc univ Louisville 78« cb 84, Athens. 
Total, 16. 



THE ROLL OF THE COUlfTY BOCIETIEB. 199 

PHTSICIANB NOT MBMBKBa OF THS SOCIETT. 

Carter, James Jackson, mc , cb 78, Athens. 

Collins, James Marshall, mc , cb 78, Athens. 

Frierson, J. G., mc , cb — , Rowland. 

Gaston, Alfred Langdon, mc univ Vanderbllt 91, cb 91, Gilbertsboro. 
Hill, Henry Willis, mc univ New York 49, cb 77, Mooresville. 
Hill, James W., mc univ Vanderbilt 84, cb 84, Mooresville. 
Kyle, William Bailey, mc Alabama 89, cb 89, LientzYille. 
Liindsey, Eugene C, mc univ Vanderbilt — , cb 1900, Mooresville. 
Total, 8. 

LOWNDES COUNTY MEDICAL SOCIETY— Mobile. 1876. 

orricKBS. 

President, W. B. Crum; Vice President N. O. James; Secretary, 
Frank Shackelford; Treasurer, Frank Shackelford; Health Officer, 
N. Q. James. Censors — ^A. D. Coleman, W. P. Russell, W. B. 
Crum, M. H. Hagood, N. Q. James. 

NAMES OF MEMBERS WITH THEIB COLLEGES AND POST-OFFICES. 

Bruner, Oliver Glenn, mc Alabama 89, cb 84, Ft. Deposit 

Carr, Oeorge Washington Lafayette, mc Pennsylvania 55, cb 78, 

Ft. Deposit. 
Coleman, Aurelius Daniel, mc Alabama 80, cb 80, Mt Willing. 
Crum, William Barton, mc Alabama 88, cb 88, Ft Deposit 
Gordon, Samuel A., mc Alabama 96, cb 95, Collerlne. 
Hagood, Middleton Howard, mc Alabama 98, cb 98, Mt Willing. 
James, Norman Gilchrist mc Alabama 98, cb 98, Hayneville. 
Middleton, Howard Hagood, mc Alabama 98, cb 98, Mt. Willing. 
Marlette, Cyrus Edmund, mc Louisville 80, cb 91, Hayneville. 
Powell, Clifton Woodruff, mc Alabama 91, cb 94, Letohatchie. 
Powell, George Norman, mc Alabama 96, cb 97, Davenport. 
Purifoy, Seaborn William, mc Kentucky s of m 94, cb Tuscaloosa 

94, Lowndesboro. 

Quillian, T. L., mc , cb — , Ft Deposit. 

Russell, William Payne, mc Atlanta 91, cb 91, Hayneville. 
Shackelford, Frank, mc Alabama 98, cb 98, Letohatchie. 
Weaver, William Calvin, mc univ Tennessee 83, cb 83, Ft Deposit 

Total, 16. 

PHYSICIANS NOT KEMBEB8 OF THE SOOIETT. 

Cllley, Phillip Noble, mc Louisville 48, cb 78, Lowndesboro. 
Dilbum, Samuel George, mc Alabama 75, cb 78, Braggs. 
Harrison, King W., mc Alabama 96, cb 97, Palmyra. 
McQueen, Samuel Thomas, mc Pennsylvania 65, cb 78, Ft Deposit 



200 ^^^ MEDICAL A880CIATtON OF ALABAMA. 

Powell, Charles William, mc Alabama 90, cb 90, Lowndesboro. 
Reese, Charles Edwin, mc Jefferson 56, cb 78, Lowndesboro. 
Sellers, Joel Carter, mc Vanderbilt 94, cb Crenshaw 94. Thomas- 

TiUe. 
Strickland, Mack, mc Alabama 1900, cb 1900, Braggs. 
Weatherly, Charles Talliferro, mc Atlanta 74, cb 85, Benton. 
Winnemore, Samuel ESggleston, mc New York 56, cb 78, Benton. 

Total, 10. 

Moved out of the county — Dudley D. Stevens, from Judges Sid- 
ing to Brundidge, Pike county. 

Examinations — ^Mack Strickland, certificate granted. 

Deaths — ^Abram Cruzer McRea, mc univ Pennsylvania 50, Lowndes- 
boro; Samuel Taylor Peak, mc Vanderbilt 83, Benton; Edwin 
Lewis Sanderson, mc Jefferson 57, Letohatchie. 

MACON COUNTT MEDICAL SOCIETY— Selma, 1879. 

QITXCEB8. 

President, P. M. Lightfoot; Vice-President, F. M. Johnston; Sec- 
retary, P. Reynolds; Treasurer, P. Reynolds; Health Oflicer, L. 
W. Johnston. Censors — L. W. Johnston, P. Reynolds, F. M. 
Letcher, J. S. Lightfoot, J. T. May. 

NAMES or MEHBEB8 WITH THEIB OOLXJDQB8 AND F06TK»11CKS. 

Johnston, Louis William, mc Alabama 81, cb 89, Tuskegee. 
Johnston, Frank Means, mc univ of the South 1901, cb 1901, Tub- 



Letcher, Francis Marion, mc univ Louisiana 61, cb 79, Shorters. 
Letcher, Joseph Bozeman, mc Tulane 97, cb 98, Shorters. 
Lightfoot, John Steele, mc univ Nashville 68, cb 78, Cross Keys. 
Lightfoot, Philip Malcolm, mc Alabama 1900, cb 1900, Cross Keys. 
May, John Thomas, mc Alabama 91, cb 91, NotasulgSw 
Reynolds, Petit, mc Alabama 97, cb 97, Warrior Stand. 
Smith, Milton Magruder, mc univ Louisville 91, cb Jefferson 91, 

Tuskegee. 
Ward, William Solomon, mc Atlanta Southern 90, cb Chambers 95, 

Notasulga. 

Total, 10. 

FHTSICIANS NOT 1CEMBKB8 OF THE SOGOETT. 

Aikens, John Calhoun, mc Oraffenburg, 46, cb Tallapoosa 78, Nota- 
sulga. 
Breedlove, Benjamin Wilbur, mc Atlanta 93, cb 93, Tuskegee. 



THE ROLL OF THE COUNTY 80CIBTIEB. 201 

Chandler, Mosely Stuart, mc Atlanta 90, cb 90, Hannon. 
Drakeford, John Ernest, mc univ Loulsyille 92, cb 92, Klnhaw. 
Gkkutier. William James, mc only Pennsylvania 60, cb 79, Tuskegee. 
Kennebrew, Alonzo Homer, (col'd.), mc Meharry 97, cb 97, Tuskegee. 
Magruder, William Perry, mc Atlanta 90, cb 90, Tuskegee. 
Wood, George Pierce, mc Memphis Hospital 90, cb 90, Tuskegee. 
Total, 8. 

Moved into the county — ^M. S. Chandler, from Mississippi to 
Hannon. 

Moved out of the county — ^James Preston Watkins, from Society 
Hill to Opelika, Lee county; Meigs Davie, from Hardaway to 

Bxaminations — Philip Malcolm Lightfoot, certificate granted; 
Frank Means Johnston, certificate granted. 

Deaths — William Alexander Reynolds, January 11th, 1901, War- 
rior Stand; John Sistrunk, Society Hill. 

MADISON COUNTY MEDICAL SOCIBTY— Birmingham, 1877. 

OVnCEBS. 

President, J. L. Darwin; Vice-President, W. D. Pettus» Secretary, 
Edgar Rand; Treasurer, Bdgar Rand; Health Officer, W. C. Wheeler. 
Cenaor»— F. B. Baldridge, W. T. Pride, T. B. Dryer, W. C. Damall, 
W. G. Wheeler. 

NAMES OF MEMBKBS WITH THEIB COLLBQES AND POST-OFFICES. 

Baldridge, Felix Bdgar, mc univ Tulane 94, cb 96, Huntsville. 

Blanton, Charles Bdgar, mc univ Vanderbilt 82, cb 82, New Biarket. 

Brook, Osceola Judkins, mc univ Tulane 93, cb Blmore 93, Hunts- 
ville. 

Burke, James Pickens, mc univ Pennsylvania 53, cb 78, Meridian- 
vUle. 

Burman, James Fulton, mc univ Nashville 99, cb 99, Madison. 

Damall, William C, mc Nashville 90, cb Cherokee 90, Huntsville. 

Darwin, James Lanier, mc Bellevue 88, cb 90, Huntsville. 

Dryer, Thomas Bdmund, mc Alabama 86, cb Macon 86, Huntsville. 

Edelman, Louis, mc Kiningsburg 85, Curtis Ins. 91, cb Limestone 
97, Huntsville. 

Brskine, Albert Russell, mc univ Pennsylvania 51, cb 78, Hunts- 
ville. 

Fletcher, Richard Matthew, Sr., mc univ Pennsylvania 54, cb 78, 
Madison. 

Fletcher, Richard Matthew, Jr., mc Alabama 94, cb 94, U. S. Army. 

Qraham, Benjamin Bmmett, mc univ of the South, Sewanee, 94, cb 
Jackson 94, Ourley. 



202 ^^^ MEDICAL ASSOCIATION OF ALABAMA. 

Haden, William Wright, mc univ Vanderbilt 90, cb 92, Owens X 

Roads. 
Hall, Benton, mc univ Tulane 1900, State Board 1900, Huntsville. 

Hampton, John P., mc , cb 78, Meridianville. 

Haney, Julius Tilman, mc Alabama 91, cb Colbert 92, Madison. 
Heffleflnger, Marion Lorain, mc S of M Kentucky 94, cb 95, Hunts- 

vilUe. 
Lowry, Samuel Hickman, mc Bellevue 73, cb 78, Huntsville. 
McDonnell, Henry, mc univ Louisiana 68, cb 78, Huntsyllle. 
Moorman, M. R., mc univ of the South 1901, cb 1901, Huntsville. 
Pettus, Claude, mc univ Vanderbilt 96, cb Limestone 96, Monrovia. 
Pettus, William David, mc univ Vanderbilt 68, cb 78, Rep. 
Pride, William T., mc Tulane 95, cb 95, Madison. 
Rand, Edgar, mc Alabama 78, cb Lawrence 78, Huntsville. 
Westmoreland, Hawkins D., mc univ Vanderbilt 92, cb Limestone 

93, Huntsville. 
Wheeler, William Camp, mc Bellevue 62, cb Colbert 81, Huntsville. 
Williamson, Edwin Oliver, mc Chattanooga 98, cb 98, Qurley. 

Total, 28. 

PHYSICIANS NOT MEMBEBS OF THE 80CIETT. 

Allen, Alfred Sidney, mc Alabama 81, cb Tuscaloosa 88, New Mar- 
ket 

Brandon, T. H. (col.), mc Denver 98, cb 99 

Brouillette, Pierre L., mc Ohio 71, cb 84, Huntsville. 

Buchanan, Roy M., mc univ Tennessee 99, cb 1900, Toney. 

Burrett, William, (Homeopath), mc univ Vanderbilt 90, cb 97, 
Huntsville. 

Burwell, Edward D., mc S of M Kentucky 78, cb 78, Huntsville. 

Carpenter, James Allen, mc Alabama 96, cb 96, New Hope. 

Cochran, Robert E. , (Botanic), mc univ Boston 85, cb Mobile 85, 
Huntsville. 

Duffleld, Alfred Manley, (Homeopath), mc univ Vanderbilt 86, 
cb 86, Farley. 

Farley, John Benton, mc univ Vanderbilt 86, cb 86, Farley. 

Flint, James C, mc univ Louisville 78, cb 78, Gurley. 

Hatcher, Archie W., mc , cb 82, West Huntsville. 

Hensley, William Thomas, mc univ Nashville 78, cb 78, Trlana. 

Hurtzler, John, (Homeopath), mc univ Nashville 78, cb 82, Trl- 
ana. 

Hinds, Byron William, mc univ Nashville 66, cb 78, New Hope. 

Horton, John Jackson, mc univ Vanderbilt 81, cb Jackson 84, New 
Market. 

Johnson Henry Raymond, mc Vanderbilt 87, cb Marshal 87, New 
Hope. 



THE ROLL OF THE COUNTY SOCIETIES. 203 

Ldxmcomb, Albin WlUshlre, mc univ Vanderbllt 96, cb 96, New 

Market. 
Scruggs, Burgess E. (col.), mc univ Nashville 70, cb 79, Huntsville. 
Shelby, Anthony B., mc , cb 78, Huntsville. 

Total, 20. 

Moved into the county — Edgar Rand, from Lieighton, Lawrence 
county, to Huntsville; M. R. Moorman, from SomerviUe, Tenii., 
to Huntsville; I. W. Howard, from Scottsboro, Jackson county, to 
Huntsville. 

Moved out of the county — ^F. H. May, Huntsville to Birmingham; 
Irvine W. Patton, U. S. Army, Philippine Islands. 

Bzaminatlons — J. F. Burman, (examination held in 1899), cer- 
tificate, granted; R. M. Buchanan, certificate granted; T. H. Bran- 
don, (col.), (examination held in 1899,) certificate granted; M. 
R. Moorman, certificate granted; J. L. Ford, certificate granted. 

Deaths — William Q. McKelvey, of suppurative hepatitis, Febru- 
ary, 1901; Anthony Natalie Glover, Owens X Roads. 

MARENCK) COUNTY MEDICAL SOCIETY— Birmingham, 1877. 

OFFICEBS. 

President, C. B. Whitfield; Vice-President, C. B. Thomas; Sec- 
retary, A. P. McArthur; Treasurer, J. B. Whitfield; Health Offi- 
cer, W. L. Kimbrough. CJensors — ^J. H. George, S. P. Hand, D. 
C. Moseley, W. L. Kimbrough, J. R. Goodloe. 

ITAliSS or MSMBEB8 WITH THEIB COLLEGES AND FOST-OFFICBS. 

Fescue, Francis Lewis, mc Jefterson 84, cb Perry 85, Demopolis. 

George, James Hosea, mc South Carolina — , cb 78, Linden. 

Goodloe, John Russell, mc univ Vanderbllt 93, cb Sumter 94, Demo- 
polis. 

Hand, Samuel Patton, mc univ Louisiana 83, cb Sumter 83, Demo- 
polis. 

Jones, Green Irvin, mc Atlanta 82, cb — , Jefferson. 

Jones, James D., mc Alabama 94, cb 94, Sweet Water. 

Kimbrough, William Leonard, mc univ Louisiana 83, cb 93, Linden. 

Lockhart, William Crocheron, mc Alabama 89, cb 89, Dayton. 

McArthur, Andrew Patterson, mc Alabama 85, cb Mobile 85, Rem- 
bert. 

McCants, Robert Bell, mc Georgia Southern 82, cb 82, Demopolis. 

Skinner, John S., mc Alabama 97, cb 98, Shlloh. 

Smith, Seth David, mc univ Louisiana 54, cb 78, Demopolis. 

Thomas, Charles Brooks, mc Atlanta Southern 83, cb 83, Thomas- 
ton. 



204 ^^^ MEDICAL ASSOCIATION OF ALABAMA. 

Whitfield, Charles Boaz, mc phys and surg New York 71, cb 78, 
Demopolis. 

Whitfield, George, mc univ Pennsylvania 58, cb 78, Old Spring Hill. 

Whitfield, James Bryan, mc univ Pennsylvania 67, cb 82, Demo- 
polis. 

Wilson, Isham Griffin, mc univ Louisiana 58, cb Dallas 78, Demo- 
polls. 
Total, 17. 

Honorary Member. 

Evans, Josiah Thomas, mc Jefferson 67, cb 78, Myrtlewood. 

PHYSICIANS NOT MEMBERS OF THE SOOIETT. 

Barron A. Lee, mc Memphis Hospital 98, cb 98, Sweet Water. 

Cole, William W., mc Pennsylvania 50, cb — , Jefferson. 

Gillespie, Robert Clanton, mc univ Louisville 83, cb 83, Putnam. 

McCorkle, Thomas James, mc Alabama 83, cb 83, Slddonsville. 

Moseley, Daniel Coleman, mc Alabama 88, cb — , Faunsdale. 

Nichols, James Eli, mc Alabama 91, cb — , Nicholsville. 

Pegram, William Edward, old law, 44, cb 79, Dayton. 

Poellnitz, Benjamin Bruno, mc univ Louisiana 47, cb 86, Rembert 

Ruffin, James Sterling, mc univ Pennsylvania 49, cb 78, Demopolis. 

Slade, Henry, mc Alabama 72, cb 87, Magnolia. 

Stone, Augustus Bosworth, mc Alabama 86, cb Baldwin 86, Demo- 
polis. 

Stone, Sardine Graham, mc Alabama 87, cb Calhoun 87, Nanafalia. 

Tucker, William Sidney, mc S of M Kentucky 90, cb 93, Luther's 
Store. 

Wood, John Hackworth, mc Alabama 86, cb 86, Dixon's Mills. i 

Total, 14. 

Moved out of the county — Bryan Watkins Whitfield, from Demo- 
polis to Nauvoo, Walked county. 

Deaths — Edmund Strudwick, mc Jefferson 57, cb 78, of la 
grippe, May 22, 1900. 

MARION COUNTY MEDICAL SOCIETY— Montgomery, 1888. 

OmiGEBS. 

President, A. L. Moorman; Vice-President, M. C. Martin; Secre- 
tary, C. L. Woods; Treasurer, J. H. Stone; Health Officer, J. R. 
Burleson. Censors — ^J. R. Burleson, K. B. Gk)ggans, Warren 
Guy ton, John Sherman, C. L. Woods. 

NAMES OF MEMBERS WITH THEIB COLLEQES AND POST-OFFICES. 

Burleson, John Rufus, mc Memphis Hospital 97, cb 97, Hamilton. 

Clark, William Felin, ng. cb 88, Hamilton. 

Bmest, James Franklin, ng. (old law), cb 88, Winfield. 



THE ROLL OF THE COVHTY SOCIETIES. 205 

Ck>ggans, Kimbro Buck, mc Memphis Hospital 98, cb 98, Hackle- 
berg. 

Guyton, Warren, mc Kentucky 79, cb 88, Hamilton. 

Johnson, John Carroll, mc LouisYille 92, cb Fayette 92, Olen Allen. 

Martin, Middleton C, ng, cb 88, Hamilton. 

McCreary, William Jefferson, mc Memphis 93, cb 93, Quin. 

Moorman, Achilles Luclan, mc Kentucky 70, cb 88, Bexar. 

Morton, T. Clark, mc Chattanooga — , cb Fayette 88, Winfleld. 

Palmer, Benjamin F., ng, cb 88, Palmer. 

Sherman, John, mc Atlanta 96, cb Marshall 96, Bear Creek. 

Stone, John Henry, mc Vanderbilt 98, cb 1901, Tremont, Miss. 

Woods, Clarence Love, mc Memphis 98, cb Lamar 98, Hamilton. 
ToUl, 14. 

PHTSICIANS NOT MEMBEBS OF THE SOCIRT. 

Cochran, William Jefferson, ng, cb 88, Gold Mine. 
Holloday, Walter Scott, ng, cb 88, Bexar. 
Palmer, R. R., ng. cb 88, Bexar. 
Roden, V. G., ng, cb 88, Bear Creek. 
Shelton, William, ng. 
Williams, E. L., ng, cb 88, Winfleld. 
Total, 6. 
Illegal — Brooks, T. P. W., Hackleburg. 

Moved into the county — John Sherman, from to Bear 

Creek. 

Moved out of the county — J. A. Jackson, from Glen Allen to Gat- 
man, Miss.; James L. Patton, from to Detroit, Lamar county. 

Examinations — James Luther Patton, Memphis M. H. C, 1900, 
certificate granted. 

MARSHALL COUNTY MEDICAL SOCIETY— Anniston, 1886. 

OFFICEBS. 

President, T. A. Casey; Vice-President, S. M. Elrod; Secretary, 
M. P. Stephens; Treasurer, M. P. Stephens; Health Oflicer, P. 
B. Lusk. Censors — P. B. Lusk, T. A. Casey, P. M. Baker, D. 
A. Morton, S. M. Elrod. 

NAMES OF MEMBERS WTTH THEIB CX}LLEaES AND POST-OFFICES. 

Baker, P. M., mc Atlanta Southern 92, cb Blount 94, Boaz. 
Casey, Thaddeus Alonzo, mc Vanderbilt 91, cb 91, Albertville. 
Davis, Samuel J., mc Atlanta 82, cb Randolph 82, Albertville. 
Elrod, Samuel Martin, mc Vanderbilt 94, cb DeKalb 94, Albertville. 
Elrod, William Addison, mc univ of South 1901, cb 1901, Albertville. 



206 ^^^ MEDICAL AB800IATI0N OF ALABAMA. 

Hall, William Presley, mc Atlanta 86, cb 86, AlbertYille. 
Jones, Thomas A., mc Birmingham 97, cb Chilton 97, Hyatt. 
Lusk, Phocean B., mc Bellevue 91, cb 91, Guntersville. 
Morton David A., mc Chattanooga 96, cb 96, Boaz. 
Noel, William Lewis, ng, cb 86, Boaz. 

Shlpp, Montgomery Gilbert, mc Vanderbilt 1901, cb 1901, Martling. 
Stephens, Miles P., mc uniy Grant 94, cb Blount 94, Reedbrook. 
Total, 12. 

PHYSICIANS NOT MEMBERS OF THE 80CIETT. 

Boyd, J. W., ng, Boaz. 

Collins, David, mc univ Vanderbilt 1901, cb 1901, Mid. 

Dodd, J. T., illegal, Boaz. 

Dowdy, Lee, ng. illegal, Martling. 

Hinds, Montgomery L., mc Vanderbilt 91, cb Cullman 92, Arab. 

Hinds, William, mc Alabama — , cb Blount — , Arab. 

Jackson, J. M., mc , cb — , Guntersville. 

Jordan, David Carnes, mc Memphis 92, cb 92, Guntersville. 
Lowery, John, ng, cb 86, McLarty. 
McGahey, Joseph Jefferson, ng, cb 86, Columbus City. 
Noel, William Earl, mc univ Grant 99, cb Jackson 1900, Marshall. 
Parris, Daniel, mc univ Vanderbilt 01, cb 01, McVille. 
Total, 12. 

Moved out of the county — J. J. Patterson, from Marshall to 
Texas; Millard F. Patterson, from Mid to Texas. 

Examinations — D. Bruce Collins, Vanderbilt 1900, certificate 
granted; William Addison Elrod,univ of South, 1900, Certificate 
granted; James Tolliver Elrod, mc univ of South 1900, certificate 
granted; John Calhoun Harris, mc Chattanooga 1900, certificate 
granted; Daniel Parris, mc Chattanooga 1900, certificate granted; 
Montgomery, Gilbert Shipp, mc Vanderbilt 1900, certificate granted; 
William Pelham Turk, mc Atlanta 92, certificate granted; Delimus 
Wesley Wilson, mc Chattanooga 1900, certificate granted. 

Deaths — ^William M. Scarbrough, ng, cb 87, Albertville. 
MOBILE COUNTY MEDICAL SOCIETY— Mobile, 1878. 

OFFICERS. 

President, C. N. Owen; Vice-President, W. T. Henderson; Secre- 
tary, J. T. England; Treasurer, J. G. Thomas; Health Officer, P. 
J. M. Acker. Censors — G. A. Ketchum, G. Owen, J. G. Thomas, 
C. A. Mohr, V. P. Gaines. 

NAMES OF MEMBERS WITH THEIR COLLEGES AXD POST-OFFICES. 

Acker, Paul Jerome Morris, mc Alabama 92, cb 92, Mobile. 
Bancroft, Marion Joseph, mc Alabama 99, cb Mobile 1900, Mobile. 



THE ROLL OF THE COUNTY BOOIETIEB. 207 

Bondurant, Eugene DuBose, mc univ Virginia 83, cb Hale 83, Mobile. 

Campbell, Douglass Qwln, mc Alabama 96, cb 96, Mobile. 

Crampton, Anson Lucius, mc Belleyue 65, cb 88, Mobile. 

Eiiigland, John Tillman, mc Alabama 99, cb 99, Mobile. 

Fonde, Qeorge Heustis, mc Alabama 97, cb 97, Mobile. 

Fonde, Keith, mc Alabama 94, cb 94, Citronelle. 

Frazer, Tucker Henderson, mc Alabama 88, cb Lee 88, Mobile. 

Gaines, Vivian Pendleton, mc Alabama 72, phys and surg New 
York 73, cb Choctaw 79, Mobile. 

Goldthwaite, Henry, mc Alabama 96, cb 96, Mobile. 

Goode, Rhett, mc Alabama 71, cb 78, Mobile. 

Goodman, Duke Williams, mc univ Louisiana 91, cb 92, Mobile. 

Henderson, William Thomas, mc Detroit 96, cb 97, Mobile. 

Hendon, James Jefferson, mc Alabama 86, cb 86, Mobile. 

Hirshfield, Henry Phillips, mc univ Pennsylvania 78, cb 78, Mobile. 

Howard, Percy John, mc Alabama 96, cb 96, Mobile. 

Inge, Henry Tutwiler, mc univ New York 83, cb 83, Mobile. 

Inge, James Tunstall, mc univ New York 94, cb 94, Mobile. 

Inge, Richard, mc univ New York 71, univ Virginia 79, cb Hale 
78, Mobile. 

Jackson, William Richard, mc Alabama 88, cb 88, Mobile. 

Ketchum, George Augustus, mc univ Pennsylvania 46, cb 78, Mo- 
bile. 

Killebrew, J. Buckner, mc univ Virginia 96, cb Tuscumbia 97, Mo- 
bile. 

Mar^chal, Edwin Lesley, mc Alabama 70, cb Baldwin 86, Mobile. 

Mcintosh, William Pade, U. S. M. H. S., Mobile. 

Mohr, Charles A., mc Alabama 84, cb 92, Mobile. 

Mohr, Herman Brent, mc Alabama 91, cb 92, Mobile. 

Owen, Calvin Norris, mc Alabama 88, cb 88, Mobile. 

Owen, Goronway, mc univ Pennsylvania 57, cb 78, Mobile. 

Oates, William Henry, mc Bellevue 98, cb 1900, Mobile. 

Pape, William Bamemore, mc Alabama 82, cb 82, Mobile. 

Porter, Ira Webster, mc Alabama 92, cb 92, Mobile. 

Pugh, Sidney Stewart, mc univ Louisiana 89, cb Clarke 89, Mobile. 

Sanders, William Henry, mc Jefferson 61, cb 78,Mobile. 

Scales, Thomas Sidney, mc phy and surg New York 67, cb 78, Mo- 
bile. 

Scales, Willis West, mc Alabama 96, cb 96, Mobile. 

Sledge, William Henry, mc Alabama 80, cb Sumter 80, Mobile. 

Tam, Silas Springer, mc Alabama 94, cb 94, Mobile. 

Terrlll, Joshua D., mc Ohio 85, cb 92, Mobile. 

Thomas, James Grey, mc univ Pennsylvania 56, cb 78, Mobile. 



208 ^^^ MEDICAL ASSOCIATION OF ALABAMA. 

Thomas James Qrey, Jr., mc Alabama 98, cb 99, Mobile. 
Wright, Rufus Ashe, mc Alabama 96, cb Sumter 90, Mobile. 
Total, 42. 

PHYSICIANS NOT MEMBERS OF THE SOCIETT. 

Blewitt, Means, mc , cb , Citronelle. 

Clarke, W .H., mc Alabama 94, cb — , Mobile. 

Dickson, T. Aubrey, mc univ Tulane 92, cb Montgomery 92, Mobile. 

Edmunds, Samuel C, mc univ Louisville 56, cb 92, Spring Hill. 

Edwards, William, mc Alabama 80, cb 80, Bayou La Batre. 

Gaines, Marion Toulmin, mc Alabama 90, cb 92, ToulminyiUe. 

Glass, Parker Josiah, mc Alabama 84, cb 85, Mobile. 

Hall, Alexander P., mc univ Louisiana 59, cb 78, Mobile. 

Harris, Thomas Nathaniel, mc Meharry 99, StaAe Board 99, Mobile. 

Harris, Oliver H., mc Alabama 95, cb 96, Mobile. 

Hawley, John B., mc — , cb — , Mobile. 

Johnston, David Elijah, mc Georgia 68, cb 78, Mobile. 

Jones, Paul Ray, mc univ Vanderbilt 98, cb Franklin 98, Whistler. 

Lyon, George G., mc Pulte (Homeopathic) 88, cb — , Mobile. 

Malay, Ranney, Phelps, mc Alabama 84, cb Elmore 84, Whistler. 

Mastin, Claudius Henry, Jr., mc univ Pennsylvania 84, cb 84, Mo- 
bile. 

Mastln, William McDowell, mc univ Pennsylvania 74, cb 78, Mobile. 

Michael, Jacob G., mc univ Virginia 60, cb 78, Citronelle. 

Myers, Augustus P., mc St Louis (Homeopathic) 88, cb — , Mobile. 

Roemer, Francis John Baptiste, mc univ Louisiana 36, cb 78, Spring 
Hill. 

Roe, Charles K., mc , cb — , Spring Hill. 

Sawyer, Julian E., mc univ Louisville 96, cb Geneva 96, Mobile. 

Sherard, Frank Ross, mc univ Pennsylvania 94, cb 94, Mobile. 

Ward, Alfred G., Jr., mc Alabama 94, cb 94, Mobile. 

Ward, William G. Jr., mc Alabama 95, cb 95, Mobile. 

Williams, Henry Rodger (col.), mc Meharry 1900, cb Morgan 1900, 
Mobile. 
Total, 26. 

Moved into the county — B. J. Post, from to Oak Grove; P. 

R. Jones, from Franklin county to Whistler; H. R. Williams 
(col.), from Morgan county to Mobile; J. B. KiUebrew, from Tus- 
caloosa county to Mobile. 

Moved out of the county — Burgett Woodcock, from Mobile to 
Vinegar Bend, Washington county. 

Examinations — ^William Wlllard S. Mason, mc New Orleans, 1900, 
certificate refused; Emmitt Hilbert Bottom, mc St. Louis 97, cer- 
tificate refused; Marlon Joseph Bancroft, mc Alabama 99, certl- 



THE ROLL OF THE COUNTY B0CIETIE8. 209 

llcate granted; William Claiborne WiUiamB, mc Alabama 1900» 
oertiflcate granted; Nathaniel Scales Gay, mc Alabama 1900, certi- 
ficate granted; William Henry Oates, mc Bellevue Hospital 98, certi- 
ficate granted. 

Death— Miles Edward McCarty, Whistler. 

MONROE COUNTY MEDICAL SOCIETY— Birmingham, 1877. 

orricEBS. 

President, F. S. Dally; Vice-President, C. E. Bizzele; Secretary, 
J. M. Wiggins; Treasurer, J. M. Wiggins; Health Officer, J. M. 
Wiggins. Censors — ^W. H. Hestle, W. J. Mason, J. W. Ruth- 
erford, J. W. Busey. 

KAMSS or MEMBERS WrTH THEIB COLLEOES AND POST-OFFICES. 

Abemathy, William Henry, mc Pennsylvania 48, cb Wilcox 77, 

Tinela. 
BIzzelle, Clarence Eugene, mc univ Vanderbilt 93, cb 93. Monroe- 

viUe. 
Busey, John W., mc Alabama 94, cb 94, Jones' Mill. 
Burroughs, William Monroe, mc South Carolina 69, cb 77, PineviUe. 
Chapman, William Rufus, mc Georgia Reform 79, cb 79, Simpkins- 

YiUe. 
Cole, D. D., mc Alabama 98, cb 98, Mt. Pleasant. 
Dally, Fielding Straughn, mc Alabama 71, cb 77, Kempyille. 
Hestle, William Monroe, mc Alabama 95, cb 86, Buena Vista. 
Mason, Francis Henry, mc Alabama 91, cb 91, Tinela. 
Mason, William Joseph, mc Atlanta 84, cb Wilcox 84, Actiyity. 
Rutherford, James Wallace, mc Alabama 93, cb 93, Franklin. 
Scott, Gladin Gorin, mc univ Louisyille 86, cb 86, Mt Pleasant. 
Stallworth, William Allen, mc Alamaba 93, cb 93, PineyiUe. 
Wiggins, James Monroe, mc Alabama 78, cb 78, Monroeyille. 

Total, 14. 

PHTSICIANS NOT MEMBERS OF THE SOCIETT. 

Draughan, Robert I., mc , cb — , Perdue Hill. 

Gailiard, George Walter, mc uniy Louisyille 82, cb 83, Perdue Hill. 
Russell, James Thomas, mc Georgia Reform 66, cb 77, Monroeyille. 
Total, 3 . 

MONTGOMERY COUNTY MEDICAL SOCIETY— Euf aula, 1878. 

OFFICEBS. 

President, Robert Goldthwalte; Vice-President, F. H. McConnico; 
Secretary, C. T. Pollard; Treasurer, Shirley Bragg; Health Officer, 
R. N. Pitts. Censors — Glenn Andrews, B. R. Pearson, M. L. Wood, 
J. L. Gaston, W. G. Bibb. 

14 



210 ^^^ MEDICAL ASSOCIATION OF ALABAMA. 

NAMES OF MEMBEBS WITH THEIB OOLLBOES AND FOBT-OFFICE8. 

Anderson, John Mordecia, mc univ City New York 91, cb 91, Mont- 
gomery. 

Andrews, Glenn, mc unlv City New York 86, cb 86, Montgomery. 

Baker, James Normant, mc unlv Virginia 98, cb 1900, Montgomery. 

Baldwin, Benjamin James, mc Bellevue 77, cb 83, Montgomery. 

Battle, Joseph Thomas, mc Georgia 67, cb Barbour 87, Highland 
Park. 

Billing, Samuel Aydelotte, mc Bellevue 97, cb 97, Montgomery. 

Bibb, William George, mc unlv Vanderbilt 78, cb 78, Montgomery. 

Bragg, Shirley, mc Alabama 75, cb Lowndes 79, Montgomery. 

Chapman, Benjamin Sidney, mc univ City New York 92, cb 92^ 
Montgomery. 

Dennis, George A., mc Atlanta Southern 93, cb Autauga 93, Mont- 
gomery. 

Gaston, John Brown, mc unlv Pennsylvania 55, cb 78, Montgomery. 

Gaston, Joseph Lucius, mc phys and surgs New York 85, cD 88, 
Montgomery. 

Goldthwalte, Robert, mc Bellevue 93, cb 94, Montgomery. 

Henry, John Hazzard, mc Philadelphia 51, cb Dallas 79, Mont- 
gomery. 

Hill, Luther Leonldas, mc unlv City New York 81, cb Jefferson 81, 
Montgomery. 

Hill, Robert Somervllle, mc univ City New York 91, cb 91, 
Montgomery. 

Hill, Robert McCullough, mc unlv City New York 60, cb 78, Mt. 
Meigs. 

Hogan, Samuel Mardls, mc unlv Louisville 73, cb Bullock 80, Mont- 
gomery. 

Jackson, Walter Clark, mc unlv Pennsylvania 52, cb 78, Mont- 
gomery. 

Johnson, Oscar, mc Alabama 96, cb Pike 96, Downing. 

Klrkpatrlck, Milton Barnes, mc unlv Tulane 96, cb Crenshaw 96, 
Montgomery. 

Law, William Lamar, mc unlv Tulane 94, cb Dallas 95, Montgom- 
ery. 

Mason, Joseph Crump, mc Bellevue 81, cb 81, Snowdoun. 

McConnlco, Frank H„ mc unlv Tulane 99, cb Wilcox 99, Montgom- 
ery. 

McCrummln, Norman Henry, mc unlv Vanderbilt 84, cb 85, Ramer. 

Michel, Richard Frazer, mc South Carolina 47, cb 78, Montgomery. 

Montgomery, Arthur Hugh, mc Atlanta 98, cb 98, Montgomery. 



THE ROLL OF THE COUNTY 80CIETIEB. 211 

Naftel, St John, mc unlv City New York 59, cb Lowndes 78^ 
Montgomery. 

Person, Benjamin Rush, mc Alabama 81, cb 81, Montgomery. 

Pearson, Coleman Ferrell, mc Alabama 1900, cb 1900, Montgomery. 

Persons, Henry Stanford, mc univ Virginia 93, cb Lee 94, Mon^ 
gomery. 

Pitts, Robert Newton, mc Atlanta 90, cb Russell 90, Montgomery. 

Pollard, Charles Teed, mc univ Tulane 97, cb 97, Montgomery. 

Powell, Claudius William, mc Alabama 88, cb 88, Fleta. 

Robinson, Louis Dominick, mc univ Tulane 96, cb 96, Montgomery. 

Rushing, Thomas Elbert, mc Alabama 90, cb 91, Pike Road. 

Sadler, John Milton, mc univ Louisiana 78, cb Perry 78, Montgomr 
ery . 

Sadler, Wilbur Fisk, mc phy and surg Baltimore 91, cb Autauga 91» 
Montgomery. 

Steiner, Samuel Jackson, mc univ Vanderbilt 79, cb 79, Mont- 
gomery. 

Stevenson, Forney Caldwell, mc phy and surg New York 93, cb* 
Calhoun 93, Montgomery. 

Stough, Thomas Jefferson, mc univ Tennessee 93, cb Crenshaw 93» 
Chisholm. 

Sturm, Max, mc Ohio 89, cb Autauga 95, Montgomery. 

Thigpen, Charles Alston, mc univ Tulane 88, cb Butler 88, Mont- 
gomery. 

Thorlngton, Thomas Chilton, mc univ Tulane 94, cb 94, Mont- 
gomery. 

Townsend, A. F., mc , cb — , Pine Level. 

Townsend, James B., mc , cb — , Pine Level.. 

Waller, George Piatt, mc univ City New York 92, cb 92, Mont- 
gomery. 

Watkins, Isaac LaFayette, mc Bellevue 78, cb Bullock 86, Mont- 
gomery. 

Weeden, Hamilton, mc Alabama , cb Barbour — , Montgomery* 

Wilkerson, Wooten Moore, mc univ City New York 80, cb Perry 80, 
Montgomery. 

Wilkerson, Charles Walter, mc univ Tulane 98, cb Perry 98, Mont- 
gomery. 

Wood, Milton LeOrand, mc Bellevue 77, cb 84, Montgomery. 
Total, 62. 

PHTSI0IA1T8 NOT mnfimw OF TBS 80CIBTT. 

Brown, James Mack, mc Alabama 89, cb 89, Sellers. 
Buchanan, J. P., mc Alabama 90, cb Butler 90, Montgomery. 



212 r^^ MEDICAL ASaOCIATION OF ALABAMA, 

Calloway, James Wesley, mc unlv Vanderbilt 81, cb 82, Snowdoun. 

Centerfit, Samuel Earle, mc unlv City New York 98, State Board 
99, Montgomery. 

Cutts, William Parsons, ng, (old law), cb 78, Chambers. 

Davis, Leroy W., mc Georgia 57, cb 78, MorganvlUe. 

Duncan, Thomas, mc Alabama 92, cb 92, Mt Carmel. 

Dungee, Alfred Coleman (col.), mc Howard 89, State Board 91, 
Montgomery. 

Grimes, Erasmus Darwin, mc unlv Louisville 66, cb 77, Montgom- 
ery. 

Harris, Andrew Jackson, mc , cb 86, Laplne. 

Jackson, Edward Beatty, mc Alabama 85, cb 85, Ramer. 

Kendrick, William Toulmin, mc Atlanta 76, cb Butler 78, Mont* 
gomery. 

Kirk, Eben Bell, mc Alabama 85, cb 85, Montgomery. 

McDade, James, mc Gtoorgla 72, cb 78, Waugh. 

McLean, James, mc unlv Louisville 66, cb 78, Hope Hull. 

Merriwether, James L., mc , cb — , Mathews. 

Nicholson, John Cogbum, mc Jefferson 55, cb 75, Mt. Meigs. 

Patterson, Daniel S., mc , cb — , Montgomery. 

Sankey, George L., mc unlv Louisville 77, cb 78, Tharln. 

Sankey, John Thomas, mc , (retired), cb 78, Tharln. 

Scott, David H. C. (col.), mc Nashville 95, cb Jefferson 95, Mont- 
gomery. 

Stone, Henry Llewellen, mc unlv Maryland 68, (retired), Mont- 
gomery. 
Total 22. 

Moved into the county — J. M. Wallace, from Tallassee, Elmore 
county, to Montgomery; Gramlin, from to Montgomery. 

Moved out of the county — James A. Wilkinson, from Montgom- 
ery to Flomaton, Escambia county. 

Examinations — ^J. N. Baker, ceriflcate granted; C. F. Pearson, 
certificate granted. 

Deaths — ^Jesse Holmes, Naftel; Thomas Alexander Means. 
♦MORGAN COUNTY MEDICAL SOCIETY— Mobile, 1876. 

OFFIdBS. 

President, F. B. Hunter; Vice-President, W. C. Buckley; Secre- 
tary, E. J. Conyngton; Treasurer, E. J. Consmgton; Health Ofllcer» 
S. L. Rountree. Censors — ^M. W. Murray, W. C. Buckley, W. L. 
Dlnsmore, S. L. Rountree, W. A. Barclift. 



THE ROLL OP THE COUNTY SOCIETIES. 215 

NAMES OF MEHBEBS WITH THBIB 00LLBGB8 AKD F081>OITIGB8. 

Barclift, Willis Anderson, mc univ Tennessee 78, cb 79, Hartsell. 
Buckley, Walter Colquit, mc phy and Surg New York 86, cb 87, De- 

catnre. 
Oonyngton, Enoch James, mc St Louis 83, cb 87, Decatur. 

Cook, W.. H., mc , cb — , FalkvlUe. 

Dinsmore, William Lewis, mc univ Vanderbilt 81, cb Lawrence 82, 

Decatur. 
Hunter, Felix Bryan, mc univ Vanderbilt 81, cb Lawrence 86, 

Falkville. 

Martin, , mc — , cb — , Basham's Gap. 

Murray, Michael William, mc univ McOlU, Montreal, Canada 90, 

cb 90, New Decatur. 
Rountree, Scott Louis, mc Jefferson 68, cb 78, Hartsell. 
Shelton, John Benjamin, mc St. Louis 92, cb Jackson 96, New De* 

catur. 
Sherrlll, Richard Byrd, mc Alabama 87, cb 84, Hartsell. 
Winton, David Macon, mc Alabama 86, cb 86, Summervllle. 

Total, 12. 

PHYSICIANS NOT MEMBEBS OF THE SOGD&TT. 

Binford, Peter, mc New Orleans 61, cb Morgan 79, Summervllle. 
Gaston, Paul Cheeves, mc univ Vanderbilt 78, cb Limestone 78,. 

New Decatur. 
Gill, Jordan Lawrence, mc univ Louisville (one course) 69, cb 78» 

Ksummerville. 
Gillespie, James Clark, mc univ Vanderbilt 81, cb Madison 81, New 

Decatur. 
Hodgeooom, Charles Ellis, mc — , 90, Talucah. 
Hodges, John Prultt, mc univ Vanderbilt 78, cb Lawrence 78, Dan- 
ville. 
Kitchens, John Mowbray, mc Alabama 86, cb Lawrence 86, Hart* 

sell. 
Oden, Alexander Hamilton, ng, cb Cullman 78, Lawrence Cove. 
Peck, Cicero Fain, mc univ Tennessee 90, cb 90, Summervllle. 
Ryan, Thomas LaFayette, mc univ Nashville 68, cb 87, Hartsell. 
Smith, John Stanhope, mc univ Louisville 47, cb 78, Woodland 

Mills. 
Steers, Willis Wood, (col.) mc univ Michigan 88, cb Montgomery 88» 

Decatur. 
Stephenson, Edison David, mc univ Nashville 68, cb 78, Danville. 
Stephenson, Richard Lewis, ng, cb 78, New Decatur. 
Stringer, William Morten, mc univ Tennessee 93, cb 99, FalkvlUev 



^14 '^^E MEDICAL ASSOCIATION OF ALABAMA. 

Thomason, William Black, mc Memphis — , cb 86, Hartsell. 
Tumey, Joseph Simpson, mc univ Vanderbilt 82, cb 82, Hartsell. 
Wllhite, Simeon Madison, mc Memphis 91, cb 91, Cedar Plains. 
Wilson, Able Robert, mc Alabama (one course), cb Lawrence 86, 

Hartsell . 

Total, 19. 

*NoTE — ^As no report has been received from Morgan county this 
year, the report of 1900 Is here reproduced. 

PERRY COUNTY MEDICAL SOCIETY— Montgomery, 1875. 

OFFICERS. 

President, Samuel Perry; Vice-President, G. R. Johnson; Secre- 
tary, J. B. Hatchett; Treasurer, E. B. Thompson; Health Officer, 

. Censors — 0. L. Shivers, J. B. Hatchett, E. B. Thompson, 

JSdward Swann, G. R. Johnson. 

NAMES OF MEMBERS WITH THEIR COLLEGES AND FOST-OFFICES. 

Barron, William Rowan, mc univ Virginia 61, cb 78, Scotts. 
"Coleman, Samuel L., mc Tulane 99, co Marengo 99, Uniontown. 
Downey, William Thomas, mc univ Louisiana 70, cb Hale 70, Fol- 

som. 
Hatchett, James Benton, mc univ Vanderbilt 90, cb Limestone 90, 

Marion. 
Johnson, Gaius Rowan, mc S of M Kentucky 92, cb 92, Marion. 
McLean, James Neal, mc Alabama 99, cb Lowndes 99, Uniontown. 
Perry, Samuel, mc South Carolina 54, cb 78, Marion. 
Bhivers, Offa Lunsford, mc univ Louisiana 73, cb Hale 78, Marion. 
Swann, Edward, mc S of M Kentucky 95, cb 95, Sprott. 
Thompson, Ellas Benson, mc univ Louisiana 69, cb 78, Marion. 
Whitfield, Sidney Thomas, mc univ Tulane 94, cb 94, Uniontown. 
Wilkerson, Charles A., mc univ New York 75, cb 78, Marion. 

Total, 12. 

PHYSICIANS NOT MEMBERS OF THE SOCIETT. 

Collier, Armstead Mayfleld, ng, cb 78, Chadwick. 

Langhome, John Miller, mc univ Pennsylvania 48, cb 78, Union- 
town. 

Pou, James Rufus, mc univ South Carolina 55, cb 78, Uniontown. 

PasTie, Thomas H., mc — , cb Shelby — , Perryville. 

Robinson, C. Byron, mc Louisville 92, cb Lowndes 92, Scotts' Sta. 

Tucker, James Buchanan, mc univ Vanderbilt 78, cb 79, Jericho. 
Total, 6 



THE ROLL OF THE COUNTY SOCIETIES. 215 

MoTed Into the county — Samuel Perry, from Birmingham to 
Marion. 

Examinations — ^Alfred Dennis Slmlngton (col.)> mc Meharry, cer- 
tificate granted. 

PICKENS COUNTY MEDICAL SOCIETY— Eufaula, 1878. 

OFFICERS. 

President, S. H. Hill; Vice-President, D. W. Glass; Secretary* 
A. A. Kirk; Treasurer, A. A. Kirk. Health Officer, A. B. Price. 
Censors— O. B. Wlmberly, A. A. Kirk, D. W. Gass, T. H. 
Henry, A. K. Collins. 

NAMES OF MEMBEBS WriH THEIB COLLEGES AND POST-OFFIOBS. 

Clear, Christopher Columbus, mc Alabama 85, cb 85, Noland. 

Collins, Alonzo K., mc — , cb — , Palmetto. 

Davis, John Longmire, mc univ Vanderbilt 88, cb 88, Gordo. 
Gass, D. William, mc univ Birmingham 99, cb 99, Pickensville. 
Henry, Taylor H., mc Memphis 99, cb 99, Palm. 
Hill, Samuel Henry, mc univ Louisville 70, cb 78, Carrollton. 
Kirk, Arthur Albertus, mc Alabama 98, cb 99, Gordo. 
Price, A. Bascome, mc Alabama 98, cb 99, Gordo. 
Upchurch, Harvey Benton, mc Alabama 92, cb 92, Carrollton. 
Wlmberly, Gilbert Bush, mc Alabama 92, cb 92, Reform. 
Total, 10. 

PHYSICIANS NOT MEMBERS OF THE SOCIEnrr. 

Agnew, James Alexander, mc Alabama 74, cb 78, Neal's Mill. 
Cook, Thomas Hugh G., mc Alabama 86, cb 86, Stone. 
Duncan, John Francis, mc Alabama 74, cb 78, McShan. 
Hancock, Jessie, mc Alabama 78, cb 78, Ethelville. 
Long, James Barckley, mc univ Louisville 9S, cb 95, Pickensville. 
Moody, Joseph, mc Alabama 71, cb 78, Franconia. 
Moorehead, Henry Clay, mc Alabama 69, cb 78, Ethelville. 
Murphy, Thomas Elmore, mc Alabama 92, cb 92, Bethany. 
Snoddy, Ephrim A., mc Alabama 97, cb 97, Garden. 
Williams, Henry Lawrence, mc Jefferson 53, cb 97, Dunbar, Miss. 
Wyatt, Rufus Riley, mc univ Nashville 84, cb 89, Memphis. 
Total, 11. 

Moved into the county — ^Robert O. Patton, from Brookwood, 
Tuscaloosa county, to Temple. 

Moved out of the county — Seaborn Edgar Deal, from Pleasant 
Grove, to Mantua, Greene county. 

Deaths — Samuel J. Sterling, mc Alabama 61, cb 78, Olney, paraly- 
Bis; James Francis Barnett, mc Alabama 92, cb 92, Temple, August, 



216 THE MEDICAL AB80CIATI0N OP ALABAMA. 

1900, angino pectoris; Thomas Harlan McKinstry, mc Alabama 9Z, 
cb 93, Carrollton, November, 1899, pneumonia. 

PIKE COUNTY MEDICAL SOCIETY— Euf aula, 1878. 

OFFICERS. 

President, W. S. Sanders; Vice-President, J. S. Beard; Secre* 
tary, P. U. Brown; Treasurer, E. G. Ford; Health Officer, C. W. 
Hilliard. Censors— P. H. Brown, J. S. Beard, W. B. Sanders^ 
P. U. Brown, J. A. McEachem. 

NAMES OF MEMREB8 WITH THEIB OOLLBQE8 AND POST-OFFICES. 

Bean, James Madison, mc Belleyue 79, cb 83, Monticello. 
Beasley, James M., mc Alabama 96, cb 96, Orion. 
Beard, Josephus Simmons, mc univ New York 76, cb 79, Troy* 
Broach, Francis Marlon, mc Atlanta 90, cb 90, Ansley. 
Brown, Pugh H., mc unlv New York 54, cb 78, Troy. 
Brown, Pugh Ulpian, mc Tulane 96, cb 96, Troy. 
Dismuke, L. L., mc Alabama 96, cb 96, China Grove. 
Ford, Elchana Gardner, ng. (old law) 66, cb 78, Troy. 
Hilliard, Charles W. Sr., mc Georgia Reform 61, cb 78, Troy. 
McEachem, Conoly Pinkney, mc Alabama 96, cb 96, Banks. 
McEachem, John Adolphus, mc Louisville 89, cb 89, Troy. 
Robertson, James Wiley, mc Atlanta 93, cb 93, Troy. 
Sanders, William B., mc Atlanta Southem 86, cb 86, Troy. 
Sanders, William Shelby, mc univ Vanderbilt 92, cb 92, Troy. 
Watkins, James Monroe, mc univ Vanderbilt 94, cb 94, Troy. 
Total, 16. 

PHYSICIANS NOT MEMBERS OF THE SOCIETY. 

Albritton, George Allen, mc Louisville 72, cb Crenshaw 82, Hen- 
derson. 

Boyd, Leroy R., mc Alabama 87, cb — , Troy. 

Crossley, William Andrew, mc South Carolina 64, cb 78, Banks. 

Dennis, S. H., mc univ GrafFenberg 68, cb 78, Olustee Creek. 

Dewberry, John Hunter, mc Jefferson 64, cb 78, Brundidge. 

Dismuke, Benjamin James, mc Georgia 67, cb 84, China Grove. 

Eiland, William A., mc Atlanta 81, cb 84, Henderson. 

Foreman, Howell, mc Jefferson 68, cb 78, Brundidge. 

Hamil, Irby Watson, mc Louisville 76, cb 78, Goshen Hill. 

Johnson, Edward Harris, mc univ Washington 69, cb Crenshaw 82» 
Troy. 

Salter. C. P., mc , cb — , Josie. 

Stough, D. B., mc , cb — , Shady Grove. 

Townsend, Austin C, mc Augusta, Ga., 61, cb 78, China Grove. 



THE ROLL OF THE COUNTY SOCIETIES. 217 

Treadwell, L. M., illegal, Troy. 

Wagner, John Troup, ng, cb Montgomery 78, Shady Grove. 
WatkinB, Lucius, Henderson. 
Total, 16. 

Moved out of the county — James C. Pennington, from Orion to 
Russell county; Charles W. HiUiard, Jr., from Troy to Elba, Coftee 
county; James T. Mullins, from Troy to Talladega; J. Knox Mul- 
lins, from Troy to Philippines (U. S. Army). 

Examinations — Francis Asbury Boswell, mc Alabama 1900, cer- 
tificate granted; John David Johnston, Atlanta College phys and 
surg 1900, certificate refused; Benjamin C. Stewart, mc Alabama 
1900, certificate granted. 

RANDOLPH COUNTY MEDICAL SOCIETY— Buf aula, 1878. 

0FFICEB8. 

President, J. W. Hooper; Vice-President, W. Q. Floyd; Secre- 
tary, P. G. Trent, Sr.; Treasurer, P. G. Trent, Sr.; Health Officer, 
P. G. Trent, Jr. Censors— W. G. Floyd, C. B. Wright, H. B. 
Disharoon, J. C. Swann, J. W. Hooper. 

NAMES OF MEMBERS WITH THEIB COLLEGES AND POST-OFFICES. 

Bonner, William Wallace, mc Atlanta Southern 92, cb 94, Rock 

Mills. 
Disharoon, Henry Beauregard, mc phy and surg Baltimore 85, cb 

86, Roanoke. 
Duke, Jefferson Davis, mc Atlanta Southern 84, cb 88, Graham. 
Floyd, William Gibson, mc unly Maryland 88, cb 92, Roanoke. 
Hooper, John Wilson, mc Jefferson 84, cb Tallapoosa 84, Roanoke. 
Jordan, Charles Alexander, mc Atlanta Southern 84, cb 87, Swann. 
Pool, Wyatt Heflin, mc Georgia 67, cb 79, Roanoke. 
Swann, Joseph Charles, mc Atlanta 90, cb 90, Wedowee. 
Traylor, George Washington, mc Georgia 91, cb 94, Lamar. 
Trent, Powhattan Glover, mc Atlanta 88, cb 88, Roanoke. 
Trent, Powhattan Green, mc Jefferson 67, cb 85, Roanoke. 
Welch, James Madison, mc Atlanta Southern 92, cb 93, Truett. 
White, Luther Leonidas, ng, cb 79, White. 

Wood, James William ,mc Atlanta Southern 97, cb Clay 97, Almond. 
Wright, Columbus B., mc Atlanta 98, cb 98, Wedowee. 

Total, 15. 

PHYSICIANS NOT MEMBERS OF THE SOCIETT. 

Black, Nathaniel Spragins, mc univ New York 61, cb Russell 87, 
Louisia. 



^18 ^^^ MEDICAL ASSOCIATION OF ALABAMA. 

Dean, Pierce Elliott, mc Alabama 92, cb 93, Wedowee. 

Dowdy, R. M., mc univ Vanderbilt — , cb — , Hlghtower. 

Gauntt, Elbert Tillman, mc Atlanta 76, cb 84, Ophelia. 

Green, Elbert Pierce, mc Georgia 99, cb 99, Wehadkee. 

Hefiin, Wilson Lumpkin, mc Georgia 48, cb 85, Roanoke. 

Hood, Joseph Robertson, mc Oglethorpe 57, cb 85, Wedowee. 

Liles, Madison DeKalb, ng, cb 79, Dingier. 

Stevens, Reuben Calyln, mc Atlanta Southern 92, cb Cleburne 97, 

Graham. 
Vineyard, James Leonard, mc Georgia Reform 49, cb 79, Rock Mills. 
Weathers, William, ng, cb 87, High Shoals. 

Total, 11. 

Moved out of the county — ^William Head McLendon, mc Alabama 
96, cb 96, from Rock Mills to West Point, Ga.; Charleton Thlmp- 
son, mc phy and surg Atlanta 99, cb 99, from Roanoke to Phoenix 
City, Lee county. 

Examinations — ^Andrew Jackson Clardy, mc Chattanooga 1900, 
scertiflcate refused. 

Death — Michael M. McManus, ng, cb 79, Lamar, cerebral trau- 
matism. 

RUSSELL COUNTY MEDICAL SOCIETY— Tuscaloosa, 1877. 

0FFI0EB8. 

President, A. R. Allen; Vice-President, John Paschal; Secre- 
tary, W. B. Prather; Health Officer, W. B. Prather. Censors — 
T. A. Johnson, W. B. Prather, A. R. Allen, G. D. Paschal, J. 
P. Norris. 

NAMES OF MEMBERS WFTH THEIB COLLEGES AND POST-OFTICES. 

Allen, Arthur Redding, mc Atlanta 96, cb 98, Oswichee. 

Echols, Moses Mason, mc Alabama 97, cb Macon 97, Girard. 

Gann, William F., mc univ Louisville 94, cb Pike 94, Crawford. 

Hendrick, Frank Gustavus, mc univ Louisville 94, cb Pike 94, Craw- 
ford. 

Jenkins, Eddie Wise, mc Bellevue — , cb 99, Girard. 

■Johnson, Thomas Abner, mc univ Tennessee 80, cb 83, Jemigan. 

Joiner, William Thomas, mc Atlanta 91, cb 91, Pittsboro. 

l<f orris, John Pinkney, mc Atlanta 91, cb 91, Uhland. 

Paschal, George Dennis, mc univ New York 72, cb 87, Hurtsboro. 

Paschal, John, mc Atlanta 98, cb 98, Glennville. 

Prather, William Butler, mc Atlanta 74, cb 88, Seale. 

Smith, Reuben Arnold, mc univ New York 52, cb 87, Hatchechubbee. 
Total, 12. 



THE ROLL OF TEE COUNTY 80CIETIE8. 219 

PHYSICIANS NOT MEMBERS OF THE SOOIETT. 

Hendrlck, Walter Branham, mc unlv Louisville 90, cb Pike 90, 

Hurtsboro. 
Howard, Thomas Watson, ng, cb 88, Girard. 
Pennington, James Cincinnatus, mc univ Tennessee 94, cb Pike 94, 

Hatchechubbee. 
Phillips, Lovlc Wynn, mc univ Tulane — , cb — , Columbus, Ga. 
Prather, Robert Clark, mc Alabama 98, cb — , Girard. 

Total, 6. 

Moved into the county — James Cincinnatus Pennington, from 
Orion, Pike county, to Hatchechubbee. 

SHELBY COUNTY MEDICAL SOCIETY— Birmingham, 1877. 

OFFICEBS. 

President, W. S. DuBose; Vice-President, E. C. Parker; Secr^ 
tary, R. H. Hargrove; Treasurer, J. R. Morgan; Health Officer, 
J. H. Gunn. Censors — ^J. R. Morgan, J. H. Williams, E. G. 
Givhan, W. S. DuBose, E. C. Parker. 

NAMES OF MEMBERS WITH THEIR COLLEGES AND POST-OFFICES. 

DuBose, Wilds Scott, mc Atlanta 58, cb 78, Columbiana. 
BUsberry, John Payne, mc univ Virginia 60, cb Montgomery 84, 

Helena. 
Givhan, Edgar Gilmore, mc Alabama 94, cb Chilton 94, Montevallo. 
Gunn, James Hamlin, mc Bellevue 69, cb 78, Calera. 
Hargrove, Robert Harris, mc univ Vanderbilt 81, Bellevue 86, cb 

Jefferson, 78, Calera. 
Lane, Kenneth Fountain, mc Atlanta 95, cb Chilton 98, Montevallo. 
McAdams, Henry Clay, mc Alabama 82, cb Mobile 82, Shelby. 
Morgan, Joseph Reid, mc univ Louisville 66, cb 78, Shelby Springs. 
Nelson, Thomas Green, mc univ National, Lebanon, O., 93, cb 9Z, 

Harpersville. 
Oliver, Christopher Carlton, mc Atlanta 69, cb 78, Calera. 
Parker, Edward Clifton, mc Tulane 99, cb 99, Shelby. 
Smith, Garland Henry, mc Alabama 87, cb 90, Ganadarque. 
Wilkinson. David Leonidas, mc univ Tulane 94, cb Autauga 94» 

Montevallo. 
Williams, Hartwell Isaac, mc Alabama 87, cb 87, Columbiana. 
Williams, John Harford, mc univ Louisville 75, cb 78, Columbiana. 
Williams, William Claiborne, mc Alabama 1900, cb Mobile 1900, 

Shelby. 

Total. 16. 



220 ^^^ MEDICAL ASSOCIATION OF ALABAMA. 

PHYSICIANS NOT MEMBEB8 OF THE 80CIETT. 

Acker, James Wilson, old law, cb Tuscaloosa 78, Montevallo. 
Batson, James Luclan, mc Kentucky S of M 1900, cb Fayette 1900^ 

Gumee. 
Boyer, Joseph Buford, mc Kentucky S of M 92, cb 92, Wllsonvllle. 
Chandler, Edward Pendleton, (old law), cb 79, Vincent. 

Cunningham, J. C, m c , cb — , Brldgeton. 

Denson, Eli Forest, mc univ Vanderbilt 79, cb 79, Pelham. 

Edwards, David W., mc Atlanta 66, cb 78, Wllsonville. 

Fields, James G., (old law), cb 78. Wllsonville. 

Griffin, Alphens J., (old law), cb 78, Lawley. 

Hays, William S., mc Alabama 87, cb 87, Helena. 

Horton, Andrew Wailes, mc Alabama 99, cb Shelby 1901, Pelham. 

McAdams, Henry Clay, mc Alabama 82, cb Mobile 82, Shelby. 

Smothers, B. H., mc , cb — , Weldon. 

Walker, Joseph Cobb, mc univ Nashville 1900, cb Blount 1900^ 

Maylene. 

Total, 14. 

Retired — Jasper Goodson, (old law) cb Tuscaloosa 78, Silurla; 
Allen Edward McGraw, mc univ Louisiana 73, cb 78, Vincent. 

Moved into the county — ^Alse Wilson Bell, from Weavers, Calhoua 
county to Vincent; John B. Ware, from Kelley's Creek, St. Clair 
county, to Vincent. 

Moved out of the county — Joseph Madison Johnson, from Pel* 
ham to Jemison, Chilton county. 

Examinations — Charles T. Acker, mc Birmingham, 1900, certi- 
ficate granted; Robert Samuel Glasgow, mc univ of South, 3900^ 
certificate granted; Andrew Wailes Horton, mc Alabama 99, cer- 
tificate granted; Joseph S. WlUmeier, Louisville H. M. C, 1900^ 
certificate granted. 

ST. CLAIR COUNTY MEDICAL SOCIETY— Euf aula, 1878. 

OFFICEBS. 

President, J. T. Brown; Vice-President, R. L. McClellan; Secre- 
tary, E. A. Harris; Treasurer, E. A. Harris; Health Officer, J. 
W. Ash. Censors — J. W. Ash, J. T. Brown, J. H. Martin, W. A» 
Beason, R. L. McClellan. 

NAMES OF MEMBERS WITH THEIB COLLEGES AND POST-OFFICEM. 

Ash, John Winston, mc univ Tulane 80, cb 80, SpringviUe. 
Bass John Burrell, mc phy and surg Baltimore 70, cb 78, Ashville. 
Beason, William A., mc phy and surg Baltimore 93, cb 93, Ashville. 
Brown, Jackson Tucker, mc Birmingham 97, cb 98, Riverside. 
Cason, Davis Elmore, mc univ Nashville 70, cb 78, Ashville. 



THE ROLL OF THE COUNTY SOCIETIES. 221 

Crump, Henry Green, ng, cb 78, Seddon. 

'Bmhrj, James Carl, me unlY Georgia 89, cb 90, Cropwell. 

Crarlington, Henry Sprlght, mc Alabama 87, cb Etowah 87, Ragland. 

Gray, JesseAlonzo, mc , cb — , Eden. 

Harris, Esau A., mc univ of the South 99, cb 99, Coal City. 

Hawkins, James Pinkney, mc Chattanooga 94, cb 99, Clear Springs. 

Laney, Marcus W., mc uniy Vanderbilt 94, cb 1900, Eden. 

McLaughlin, James Madison, mc , State Board 80, Spring- 

Yllle. 

McClellan, Robert Lee, mc Alabama 97, cb 97, Eaaonvllle. 
Martin, John Howard, mc Alabama 99, cb Blount 99, SpringriUe. 

Turner, James Perry, mc Birmingham 1900, cb 1900, Cropwell. 

Vandergrift, Washington Frank, mc univ Tulane 80, cb 80, Branch- 

viUe. 
Wheeler, Thomas Tyler, mc Chattanooga 1900, cb Cleburne 1900, 

Steel's Depot 

Total. 18. 

Honorary Memhera. 
Crump, James Wells, mc Atlanta 76 ,cb St Clair 78, Steel's Depot 

Cason, James Calvin, mc Memphis 85, cb 86, Coal City. 

Jones, James Henry, mc , cb Calhoun 78, Ragland. 

Total, 3. 

PHTSICIANB NOT MEMBERS OF THE SOCDETT. 

Alverson, Robert F., mc Alabama 93, cb 93, Coal City. 
Hamilton, Charles Henry, ng, cb Calhoun 79, Pell City. 

Spinks, J. M., mc , be — , Ragland. 

Total, 3. 

Moved into the county — J. M. Spinks, from to Ragland; T. 

T. Wheeler, from Cleburne county to Steel's Depot 

Moved out of the county — John B. Ware, from Kelly's Creek to 
Vincent, Shelby county. 

Examinations — Marcus W. Laney, certificate granted; James 
Perry Turner, mc Birmingham 1900, certificate granted. 

SUMTER COUNTY MEDICAL SOCIETY— Mooile, 1876 

OmCEBB. 

President, W. J. McCain; Vice-President. T. J. Blckley; Secre- 
tary, D. S. Brockway; Treasurer, D. S. Brockway; Health Officer, 
D. S. Brockway. Censors — D. S. Brockway, M. B. Cameron, T. 
J. Bickley, W. J. McCain, A. L. Vaughan. 

NAMES OF MEMBERS WTIH THEIB COLLEGES AND POST-OrFICES. 

Bancroft Joseph Dosier, mc univ Vanderbilt 94, cb 94, SumterviUe. 
Bickley, Thomas Jefferson, mc univ Vanderbilt 81, cb 81, Gaines- 
ville. 



222 ^^^ MEDICAL ASSOCIATIOy OF ALABAMA. 

Brockway, Dudley Samuel, mc Jefferson 81, cb 81, Llylngston. 
Cameron, Matbew Bunyan, mc Alabama 86, cb 86, SumtenrlUe. 
Gilmore, John Nell, mc New York — , cb 78, Gaston. 
Hale, Robert Hadden, mc uniy Louisville 79, cb 80, York. 
Kimbrough, T. G., mc Alabama 98, cb 98, Coatopa. 
McCain, William Jasper, m cAlabama 91, cb 91, Liyingston, 
Parham, John Calhoun, mc S of M Kentucky 77, cb 78, Gainesville. 
Reed, John H. G., mc univ Louisville 90, Bpps. 
Scales, John Patton, mc univ Louisville 97, cb 98, Brewersvllle. 
Shamberger, William Brantley, mc univ Louisville 84, cb Choctaw 

85, Rosser. 
Shaw, Robert Eugene, mc Alabama 97, cb Mobile 97, Bpps. 
Stallsworth, F. B., mc Alabama 99, cb 99, Cuba. 
Vaughan, Amos Lemuel, mc univ Louisville 84, cb 84, Cuba. 

Total, 15. 

Honorary Members. 

James, William Hamilton, mc — , cb 78, York. 
Shell, Edward Henry, mc Pennsylvania 56, cb 78, Birmingham. 
Ward, Henry Bascom, mc Alabama 78, cb 78, Cuba. 
Total, 3. 

PHYSICIANS NOT MEMBERS OF THE SOCIETY. 

Carr, Paul Ellington, mc univ Louisville 91, cb 91, Warsaw. 
Harris, Evan P., mc univ Louisville 69, cb 78, Rosser. 
Hearn, William Thomas, mc univ Louisville 82» cb 82, York. 
Nash, James Loney, mc univ Louisville 80, cb 80, Livingston. 
Shaw, Robert Wilbur, mc Alabama 1900, cb Washington 1900, Epps. 
Total 5. 

Moved into the county — Robert Wilbur Shaw, from Washington 
county to Epps. 

Examinations — Robert Ellyson Harwood, mc Alabama, certificate 
granted; Duke Price Jones, mc Alabama 1900, certificate granted; 
Dudley Stevens, univ Nashville 1900, certificate granted; WiUiaia 
Henry Stevens, mc Meharry 1900, certificate granted. 

TALLADEGA COUNTY MEDICAL SOCIETY— Annlston, 1886. 

OFFICEBS. 

President, B. B. Simms; Vice-President, J. S. McCants; Secre^ 
tary, W. G. Harrison; Treasurer, E. P. Cason; Health Oflloer,. 
W. G. Harrison. Censors— J. T. Harrison, George A. Htll, B. B^ 
Simms, S. W. Welch, J. S. McCants. 



THE ROLL OF THE COUNTY SOCIETIES. 22i 

NA31ES OF MEMBEBS WITH THEIB OOLLBGBS AND POST-OFFICES. 

Barker, Erastus Thomas, mc Memphis 99, cb Cleburne 99, East- 

aboga. 
Bishop, Wallace Reverdy, ng. State Board 95, Talladega. 

Caffey, Hugh T., mc , cb — , . 

Cason, Eugene P., mc Alabama 90, cb St Clair 90, Talladega. 
Craddock, Felix Hood, mc univ Vanderbilt 95, cb 95, Sylacauga. 
Dixon, John, mc Jefferson 56, cb 86, FayetteviUe. 
Harris, Daniel Blake, mc Atlanta Southern 97, cb Clay 98, Munr 

ford. 
Harrison, John Tinsely, mc Atlanta 81, cb 86, Talladega. 
Harrison, William Groce, mc univ Biaryland 92 cb 92, Talladega. 
Heacock, John William, mc univ Liouisiana 66, cb 86, Alpine. 
Hill, George Armstrong, mc Jefterson 70, cb 86, Wsmette. 
Hutchinson, W. H., mc Chattanooga 93, cb St Clair 97, Childers^ 

burg. 
Kent, T. J., mc Alabama 97, cb Coosa 97, FayetteviUe. 
McCants, John Samuel, mc Atlanta 66, cb 86, Talladega. 
Powell, Thomas Jefterson, mc univ Maryland 66, cb 86, Childers* 

burg. 
Pugh, Braxton Bragg, mc Alabama 89, cb Clarke 98, Ironaton. 
Simms, Benjamin Brit, mc Jefterson 85, cb Coosa 86, Talladega. 
Sims, Albert Gallatin, mc univ Nashville 69, cb 86, Renfro. 
Smith, Joseph Marshall, mc Alabama 1900, cb Coosa 1900, Sylar 

cauga. 
Thetford, William Fletcher, mc univ Louisiana 67, cb Greene 78, 

Talladega. 
Welch, Samuel Wallace, mc l;>hy and surg Baltimore 93, cb 93, 

Talladega. 
Wrenn, Edward Bailey, mc Alabama 90, cb 90, Talladega. 

Total, 22. 

Honorary Memhera, 

Hendricks, Humphrey Green, mc Philadelphia 52, cb 86, Talladega. 
Stockdale, John Lark, mc South Carolina 54, cb 86, Bos well. 
Taylor, William, mc Louisiana 52, cb 86, Tallageda. 
Vandiver, John Harrington, mc Jefferson 45, cb 86, Talladega. 
Welch, William Amerlcus, mc Jefferson 48, cb 86, Alpine. 
Total, 5. 

PHYSICIANS NOT MF.MBEB8 OF THE SOCIETT. 

Bailey, Robert Emmett, mc Atlanta 66, cb 86, Silver Run. 
Brooks, Alpheus Clin, mc Atlanta Southern 87, cb Clay 87, Lihcoln. 



224 ^^^ MEDICAL ASSOCIATION OF ALABAMA. 

Castleberry. William Trice, mc Georgia 72, cb 86, Lincoln. 

Coker, Marlon Jackson, ng, cb Clay- 87, Sylacauga. 

Colyln, James Pickett, mc Kentucky S of M 91, cb Macon 91, Lin- 
coln. 

Conway, Magnus Ell, mc unlv Vanderbllt 88, cb 88, Sylacauga. 

Donaldson, John Thaddeus, mc South Carolina 67, cb 86, Bast- 
aboga. 

Harris, Daniel Blake, mc Atlanta Southern 97, cb Clay — , Mun- 
ford. 

Pearson, James Emmett, mc Alabama 88, diploma recorded, Syla- 
cauga. 

Prescott, William Earnest, mc Birmingham 1900, cb Chilton 1900, 
Alpine. 

Pruett, E. J., mc Memphis — , cb Clay — , Sylacauga. 

Sorrel, William Henry, ng cb 82, Sylacauga. 

IVhltten, Edgar Hlnton, mc Alabama 88, cb 89, Munford. 
Total, 13. 

Moved Into the county — J. M. Smith, from Coosa county to 
Bylacauga; W. E. Prescott, from Chilton county to Alpine. 

Moved out of the county — ^Bushrod Foley Laird, from Talladega 
to Covington, Ky.; William Thomas Hamilton, from Talladega to 

Tallapoosa county; John W. Grimes, from to Coosa county; 

William Henry Harrison, from Kymulga to Barbour county. 

TALLAPOOSA COUNTY MEDICAL SOCIETY— Selma. 1879. 

OFFICERS. 

President, J. P. Motley; Vice; -President, H. S. Bruce; Secretory, 
A. LaP. Harlan; Treasurer, R. V. Salmon; Health Officer, A. LaP. 
Harlan. Censors — J. A. Goggans, A. J. Coley, R. V. Salmon, A. 
LaF. Harlan. H. T. Hamner. 

I7AME8 OF MEMBERS WFTH THEIB COLLEGES AND POST-OFFICES. 

Bruce, Homer S., mc Atlanto 91, cb Chambers 91, Camp Hill. 
<:;arleton, William George, mc unlv Vanderbllt 82, cb 82, DudleyvlUe. 
■Coley, Andrew Jackson, mc Jefferson 80, cb 81, Alexander City. 
Ooggans, James Adrian, mc unlv New York 77, cb 82, Alexander 

City. 
Orlffln, James Olln, mc Alabama 1900, cb Clay 1900, HackneyvlUe. 
Hamner, Harper Talllaferro, mc unlv Vanderbllt 89, cb Chambers 90, 

Camp HIU. 
Harlan, Aaron LaFayette, mc Alabama 86, cb 86, Alexander City. 
Harlan, John James, mc Alabama 72, cb 82, Dadevllle. 



THE ROLL OF THE COUNTY SOCIETIES. 226 

Hart, Eugene Walker, mc Baltimore 91, cb 91, Walnut Hill. 
Langley, O. V., mc Atlanta 96, cb 96, Camp Hill. 
Lilghtfoot, Robert W., mc South Carolina 62, cb 82, Alexander City. 
McLendon, Joseph Wyley, mc Jefferson 88, cb 88, Dedevllle. 
McLendon, Henry Leonidas, univ of South 99, cb Chambers 1900, 

HackneyyiUe. 
Motley. J. P. mc uniy Atlanta Southern 86, cb 86, Motley. 
Nolen, Abner Jackson, mc Loulsyille 80, cb Coosa 82, New Site 
Nolen, Isaac Daniel, mc uniy Loulsyille 92, cb Coosa 92, New Site. 
Radford, Oeorge Clements, ng, cb Clay 87, Bulgers. 
Reagan, Onslow, ng, cb 82, Alexander City. 
Salmon, Robert Vaughn, mc Alabama 75, cb 82, Dadeyille. 
Shepard, Orlando Tyler, mc Oraffenburg 54, cb 82, Tohopeka. 
Smith, Watt Francis, mc Oraffenburg 54, cb 82, Thaddeus. 
Street, Thos. Hezekiah, mc Jefferson 1900, cb 1901, Alexander City. 
Vines, Oeorge Washington, mc uniy Tulane 72, cb 82, Dadeyille. 
Ward, Lucius Cincinnatus, ng, cb 82, Dayiston. 

Total, 24. 

PHYSICIANS NOT MKMBKR8 OF THE SOCIffrT. 

Banks, Joseph W., mc Alabama 90, cb — , Jackson's Oap. 
Langley, W. T., mc Alabama 99, cb 99, Camp Hill. 
Shepard, Philip Madison, mc Oraffenburg 54, cb 82, Dadeyille. 
Spier, Alfred Alexander, ng, cb 80, Dudleyyille. 
Total, 4. 

Moyed into the county — ^James Olin Oriflln, from Millenrille, Clay 
county, to HackneyyiUe; Henry Leonidas McLendon, from Chambers 
county to HackneyyiUe. 

Examinations — ^Thomas H. Street, Jefferson mc 1900, certificate 
granted. 

TUSCALOOSA COUNTY MEDICAL SOCIETY— Birmingham, 1877. 

OFyiCEBS. 

President, W. M. Faulk; Vice-President, Sydney Leach; Secretary, 
T. M. Leatherwood; Treasurer, T. M. Leatherwood; Health Ofllcer, 
Robert Neilson. Censors — ^J. L. Fant, O. R. Rau, Sydney Leach, 
W. G. Someryille, T. M. Leatherwood. 

NAMES OF MEMBEBS WITH THEIB COLLEGES AND FOST-OFnOIS. 

Fant, Joseph Louis, mc South Carolina 76, cb Marengo 78, Tusca- 
loosa. 
Faulk, William Mark, mc Alabama 97, cb Barbour 97, Tuscaloosa. 
Fltts, Alston, mc Phys and Surg New York 95, cb 1900, Tuscaloosa. 

15 



226 ^^^ MEDICAL ASSOCIATION OF ALABAMA. 

Hitchcock, Matthew Sims, mc uniy LoulBvllle 93, cb Dallas 93, 

Brookwood. 
Jackson, Robert Dandridge, mc South Carolina 51, cb Dallas 78, 

Brookwood. 
Leach, Sydney, mc uniy Virginia 96, cb 97, Tuscaloosa. 
Leatherwood, Timothy Miles, mc Alabama 91, cb 91, Tuscaloosa. 
Lee, John Andrew, mc univ Vanderbilt 87, cb Pickens 97, Tuscaloosa. 
Little, John, mc uniy Louisiana 69, cb 78, Tuscaloosa. 
Malloy, Martin Luther, mc Alabama 99, cb Lee 99, Tuscaloosa. 
Majrfleld, Surry Foster, mc uniy Tulane 96, cb 96, Northport 
Nichols, Andrew Berry Cook, mc uniy Philadelphia 69, cb 78, Tus- 

caloosa. 
Patton, Madison Knox, mc Tulane 91, cb Greene 91, Fosters. 
Rau, George Reneau, mc uniy of the South (Sewanee) 94, cb — , 

Tuscaloosa. 
Russel, James W., mc Loulsyille 76, cb — , Tuscaloosa. 
Searcy, James Thomas, mc uniy New York 67, cb 78, Tuscaloosa. 
Someryille, William Glassell, mc phys and surg New York 89, cb 89, 

Tuscaloosa. 
Trimm, James Lewis, mc Alabama 81, cb 81, Northport. 
Taylor, William Thomas, mc Alabama 93, cb Greene 93, Hickman. 
Williamson, James Lewis, mc Alabama 81, cb 81, Tuscaloosa. 
Ward, John Hester, mc uniy of the South (Sewanee) 99, cb 1900, 

Cottondale. 
Ward, Walter R., mc Birmingham 1900, cb 1900, Tidewater. 

Total, 22. 

Honorary Member. 
Neilson, Robert, mc uniy Georgia 51, cb 78, Tuscaloosa. 

PHYSICIANS NOT MEMBERS OF THE SOGHCTT. 

Black, , mc — , cb — , Goethite. 

Caldwell, Washington Jackson, ng, cb 84, Hull. 

Cannon, Daniel Pugh, mc uniy Vanderbilt — , cb Bibb 95, Coaling. 

Cross, Thomas, mc uniy Vanderbilt — , cb — . 

Donaho, John, mc , cb — , Elbert. 

Foster, Bzra, ng, cb 78, Brookwood. 

Oliye, George Washington, mc Alabama 82, cb 83, New Lexington. 

Sellers, B. M., mc , cb — , MiUdale. 

Smothers, Wm. Jonas, mc Alabama — , cb — , Moore's Bridge. 
Smothers, Lee, mc Alabama 99, cb — , Moore's Bridge. 
Toomey, Mark Anthony, ng, cb 78, Pearl. 

Weayer, George Augustus, (col.) mc uniy Howard 97, cb Tuscaloosa 
98, Tuscaloosa. 



THE ROLL OF THE COUNTY SOCIETIES. 227 

WilklnBon, J. O., mc — , cb — , Humphrey. 
Total, 18. 

Moved Into the county— Alston Fltts, from New York to Tusca- 
loosa. 

Moved out of the county— W. B. Doughty, from Falls to Fayette, 
Fayette county; P. L. Hauler, from Tuscaloosa to Ensley, Jefterson 
county; J. W. Russey, from Tuscaloosa to Bibb county. 

Bxamlnations— Walter R. Ward, certificate granted; Alston Fitt8» 
certificate granted. 

Death — ^Alsey Clements, Vance. 

WALKER COUNTY MEDICAL SOCIETY— Mobile, 1876. 

omcsBS. 

President, J. A. Goodwin; Vice-President, G. S. Guilder; Secre- 
tary, D. M. Davis; Treasurer, D. M. Davis; Health Ofllcer, A. M. 
Stovall. Censors — J. A. Goodwin, A. M. Stovall, C. B. Jackson, 
D. M. Davis, J. M. Miller. 

2TAME8 OF MEMBERS WITH THEIB COLLEGES AND POST-OFFICES. 

Ballenger, Joseph William, mc univ Vanderbilt 84, cb Cullman 87, 
Carbon Hill. 

CamaJc, David Hubbard, old law 71, cb 84, Jasper. 

Davis, Daniel M., mc Atlanta 94, cb 94, Cordova. 

Deweese, Thomas Peters ,mc univ Vanderbilt 86, cb 86, Gamble 
Mines. 

Fleming, James A., mc Mobile 70, old law — , Horse Creek. 

Goodwin, Joseph Anderson, mc Alabama 74, cb 78, Jasper. 

Gravlee, William Lewis, mc* univ Nashville 82, cb 82, Patton Junc- 
tion. 

Guilder, George S., mc Alabama 94, cb 94, Galloway. 

Hendon, Albert Lucretius, old law 78, cb 78, Townley. 

Jackson, Charles Beuford, mc Atlanta 86, cb Tallapoosa 86, Horse 
Creek. 

Manasco, John, old law 76, cb 81, Townley. 

Manasco, Titus, mc Mempihs Hospital 96, cb 96, Townley. 

Miller, John M., mc univ Vanderbilt 85, Cordova. 

Odum, James Newton, mc Memphis Hospital 94, cb 94, America. 

Rosamond, William Cooper, old law, 66, cb 81, Jasper. 

Stovall, Andrew McAdams, mc Louisville 80, cb 81, Jasper. 

Whitfield, Bryan Watkins, mc univ Pennsylvania 63, cb Marengo 79, 
Nauvoo. 

Woodson, John A., mc univ Vanderbilt 92, cb 93, Coal Valley. 
Total, 18. 



228 ^^^ MEDICAL A880CIATI0N OF ALABAMA. 

PHTSI0IAN8 iror imfRKM or THB 80CIBTT. 

Dearth, James Kitrldge, ng, cb 88, Jasper. 

Gallagher, Larkln, mc Alabama 95, eb 96, Bldridge. 

Oarganus, William, mc Chattanooga 94, cb — , Oakman. 

Lynn, John Wesley, mc Atlanta 60, cb 81, Carbon Hill. 

Masterson, William T., mc univ LouisriUe 91, cb Franklin 91. Oak- 
man. 

Phillips, Alfred B., univ Vanderbilt 86, cb 86, Horse Creek. 

Stephenson, Hugh Watson, mc Alabama 80, cb Lawrence 88, Oak- 
man. 

Woodson, Landon Aubry, univ Virginia 61, cb 91, Patton. 

Whitney, O. H., mc Louisville 90, cb — , Fayette. 
Total, 9. 

Moved out of the county — ^Wm. H. Downing, from Cordova to — . 
WASHINGTON COUNTY MEDICAL SOCIETY— Tuscaloosa. 1887. 

OinCKBS. 

President, F. A. Webb; Vice-President, J. W. Wood; Secretary, 
L. L. Duggar; Treasurer, L. L. Duggar; Health Officer, W. E. 
Kimbrough. Censors — ^F. A. Webb, John Gordon, Chas. LeBaron, 
C. W. McCannon. 

NAMES OF MEMBEBS WITH THEIB COLLEGES AND F08TK)FFICES. 

Duggar, Llewellyn Ludwig, mc Alabama 98, cb Mobile 99, Fairford. 
Gordon, John mc Ohio 66, cb 87, Healing Springs. 
Kimbrough, William B., mc univ Alabama — , cb 87, Stephens. 
LeBaron, Charles, mc Alabama 89, cb 96, Yellow Pine. 
McCannon, Campbell Wallace, mc phy and surg Keokuk, Iowa 80, cb 

96, Deer Park. 
Shoemaker, Walton Worthy, mc Alabama 92, cb 92, Frankville. 
Webb, Francis Asbury, mc Alabama 81, cb 91, Calvert. 
Wood, John Wesley, mc univ Virginia 60, cb 87, Healing Springs. 

Total, 8. 

PHYSICIANS NOT MEMBEBS OF THE SOCIVrT. 

Woodcock, Burgett, Alabama 96, cb Mobile 97, Vinegar Bend. 

Palmer, Dabney. mc , cb — , Leroy. 

Total, 2. 

Moved into the county — Burgett Woodcock, from Mobile to Vine- 
gar Bend. 

Examinations — ^Rowell Wilbur Shaw, mc Memphis HoQ»ital 1900. 
certificate granted. 



THE ROLL OF THE OOVNTY BOOlETIEB. 229 

WILCOX COUNTY MEDICAL SOCIETY— Eufaula, 1887. 

OmOEBS. 

President, W. T. Pumell; Vice-President, A. B. Curtis; Secre- 
tary, J. C. Benson; Treasurer, J. C. Benson. Censors, L. B. Starr, 
D. F. Qaston, A. B. Curtis, T. W. Jones, J. H. Jones. 

1YAM£S or M£MBEBS WITH THBIB COLLEGES AlTD POST-OFFICES. 

Adams, David, mc Georgia 68, cb 81, Pine Apple. 
Benson, James C, mc Alabama 87, cb 87, Camden. 
Burroughs, William M., mc univ Tennessee 91, cb Clarke 92, Pine 

HiU. 

Cox, J. W., mc Alabama 95, cb 95, . 

Curtis, Alonzo Bittle ,mc Alabama 78, cb 82, Lower Peach Tree. 
Curtis, Christopher Columbus, mc Alabama 82, cb 82, Lower Peach 

Tree. 
Dale, William Bonner, mc univ Louisiana 61, cb 79 Rowell. 
Gaston, David Finis, mc univ Louisiana 62, cb 82, Gastonburg. 
Godbold, John Calhoun, mc Alabama ng, cb 79, Nellie. 
Haddox, William Thomas, mc univ Louisiana 58, cb 79, Pine HIU. 
Jones, John Paul, mc univ Louisiana 61, cb 79, Camden. 
Jones, Joseph Harvey, mc univ Louisville 80, cb 82, Oak Hill. 
Jones, Thomas Warburton, mc phy and surg New York 90, cb 90, 

Camden. 
Jenkins, Thomas Griffin, mc univ Louisiana 48, cb 79, Camden. 
Kilpatrick, Rufus Hall, mc Alabama 88, cb 88, Camden. 
Kimbrough, John Henry, mc Alabama 94, cb 94, Catherine. 
Kimbrough, Franklin Flavins, mc Alabama 90, cb 90, Arlington. 
Lee, Thomas, mc South Carolina 57, cb 80, Furman. 
Purifoy, John Howard, mc Jefferson 59, cb 81, Furman. 
Pumell, William Thomas, mc Alabama 76, cb 79, Prairie. 
Ramsey, David Wardlaw, mc univ Louisiana 70, cb 78, Pine Apple. 
Spurlin, George Green, mc univ Louisiana 92, cb 92, Camden. 
Starr, Lucius Ernest, mc Alabama 61, cb Bibb 68, Camden. 
Spier, Phillip Van Buren, mc Alabama 1900, cb 1900, Furman. 

Total, 24. 

PHYSICIANS NOT MEMBERS OF THE 80CIETT. 

Cole, William W., mc univ Pennsylvania 60, cb 79, Snow Hill. 
Cook, Samuel Benjamin H., ng, cb 85, Pine Hill. 
Hawthorne, Samuel McC, mc Alabama 89, cb 89, Pine Apple. 
King, Edward Doak, mc , cb 84, Lower Peach Tree. 



230 ^^^ MEDICAL ASSOCIATION OF ALABAMA. 

Lee, John Francis, mc univ Nashyllle 80, cb 83, AUenton. 

McWilliams, E. C, mc , cb — , Oak Hill. 

Total, 6. 

Examinations — Phillip Van Buren Spier, mc Alabama 1900, cer- 
tificate granted. 

WINSTON COUNTY MEDICAL SOCIETY— Montgomery, 1888. 

OFnCSBS. 

President, J. A. McCuUar; Vice-President, A. S. Palmer; Secre- 
tary, W. E. Howell; Treasurer, W. E. Howell; Health Officer, J. 
C. Taylor. Censors — J. C. Taylor, A. S. Palmer. J. A. McGullar, 
W. E. Howell. 

NAMES OF MBMBEB8 WITH THEIB COLLSGES AND POST-OFFICKS. 

Howell, William Edward, mc Birmingham 1900, cb 1900, Halesnrille. 

Johnson, Harvey Caloway, old law, 86, cb 86, Nauvoo. 

McCullar, James Alexander, mc univ Vanderbilt 99, cb 99, Double 

Springs. 
Palmer, Alexander S., ng, cb Marion 89, Halesnrille. 
Taylor, Joseph Calhoun, mc Alabama 88, cb 89, Halesrville. 

Total, 6. 

PHTSICIANB NOT MEMBERS OF THE 800IETT. 

Adkins, William Riley, old law, cb Tuscaloosa 78, Double Springs. 
Bonds, William Riley, mc Alabama 92, Double Springs. 
Dennis, D. R., ng, Addison. 

Ezell, E. F., mc , cb — , Lynn. 

Hood, John Wesley, old law, cb 90, Addison. 

Roden, Benjamin Wesley, old law, cb Marion 89, Haleyvllle. 

Self, , mc Chattanooga 1900, cb — , . 

Wilbom, Thomas P., mc , cb — , . 

Total, 8. 

Moved out of the county — Christian Zimmer Corns, from Delmar 
to Jefferson county. 

Examinations — ^William Edward Howell, mc Birmingham 1900, 
certificate granted; A. Costa Watts, mc Louisville 1892, certificate 
granted. 



THE ROLL OF THE COLLEGE COUNSELLORa. 231 

ROLL OF THE COLLEGE OF COUNSELLORS. 

REVISION OF lOOl, 



THE GRAND SENIOR LIFE COUNSELLORS. 
Abemathy, William Henry, Flomaton — ^Montgomery seasion. ...1875 

Cason, Davis Elmore, Ashville — HuntsviUe session 1880 

Fletcher, Richard Matthew, HuntsviUe — ^Montgomery session. .1881 

Fumiss, John Perkins, Selma — Mobile session 1876 

Gaines, Vivian Pendleton, Mobile — Selma session 1879 

Gaston, John Brown, Montgomery — ^Montgomery session 1876 

Hayes, Robert Hughes, Union Springs — HuntsviUe session 1880 

Hogan, Samuel Mardis, Montgomery — ^Montgomery session 1875 

Jackson, Robert Dandridge, Brookwood — ^Tuscaloosa session. . . .1873 

Jackson, Walter Clark, Montgomery — ^Tuscaloosa session 1873 

Jones, Capers Capehart, East Lake — Montgomery session 1881 

Ketchum, George Augustus, Mobile — ^Tuscaloosa session 1873 

McKittrick, Adam Alexander, Evergreen — Tuscaloosa session. ..1873 

Michel, Richard Frazer, Montgomery — Tuscaloosa session 1873 

Prince, Frances Marion, Bessemer — Birmingham session 1877 

Robertson, Thaddeus Lindley, Birmingham — Montgomery ses- 
sion 1881 

Sanders, William Henry, Mobile — ^Eufaula session 1878 

Starr, Lucius Ernest, Camden — Selma session 1874 

Sholl, Edward Henry, Birmingham — HuntsviUe session 1880 

Thetford, William Fletcher, Talladega — Montgomery session.... 1881 

Thomas, James Grey, Mobile — HuntsviUe session 1880 

Total, 21. 

THE GRAND SENIOR COUNSELLORS. 

Baldwin, Benjamin James, Montgomery — ^Anniston session 1886 

Bragg, Shirley, Montgomery — Greenville session 1885 

Brockway, Dudley Samuel, Livingston — ^Mobile session 1882 

Coley, Andrew Jackson, Alexander City — HuntsviUe session. . . .1891 
DeWeese, Thomas Peters, Gamble Mines — ^Birmingham session. .1894 

Franklin, Charles Higgs, Union Springs — Mobile session 1882 

Goggans, James Adrian, Alexander City — Birmingham session .. 1883 

Goods, Rhett, Mobile — Mobile session 1889 

Goodwin, Joseph Anderson, Jasper — ^Mobile session 1882 

Harlan, John Jefferson, HackneyriUe — Montgomery session.... 1888 

Hill, Luther Leonidas, Montgomery — Montgomery session 1888 

Huggins, Jacob, Newborn — Selma session , 1884 

Jones, Capers Capehart, Bast Lake— Montgomery session 1881 



23^ Tir^ MEt)ICAL A8B0OtAfIO2f OF ALABAMA. 

Inge, Henry Tutwiler, Mobile — Greenville session 1886 

J^y, Andrew. Evergreen — ^Mobile session 1882 

Kendrick, Joel Cloud, Greenville — Mobile session 1889 

LeGrand, John Clark, Birmingham — Mobile session 1889 

Lowry, Samuel Hickman, Huntsville — Greenville session 1885 

Mar^chal, Edwin Lesley, Mobile— Mobile session 1889 

Nolen, Abner Jackson, New Site— -Anniston session 1886 

Redden, Robert James, Sulligent — ^Tuscaloosa session 1887 

Searcy, James Thomas, Tuscaloosa — ^Selma session 1884 

Sledge, William Henry, Mobile— Mobile session 1882 

Stovall, Andrew McAdams, Jasper— Mobile session 1882 

Trent, Powhatan Green, Roanoke — Selma session 1884 

y/haley, Lewis, Birmingham — ^Anniston session 1886 

Wheeler, William Camp, Huntsville — ^Montgomery session 1888 

Wilkerson, Wooten Moore, Montgomery — ^Birmingham session.. 1883 

Wllkerson, Charles A., Marion — ^Birmingham session 1890 

Total, 28. 

THE SENIOR COUNSELLORS. 

Andrews, Glenn, Montgomery — Selma session 1893 

Bell, Walter Howard, Oxford — ^Birmingham session 1894 

Blake, Wyatt Heflin, Wetumpka— Montgomery session 1892 

Bondurant, Eugene DuBose, Mobile — Birmingham session 1894 

Brown, George Summers, Birmingham — ^Birmingham session .. 1894 

Cameron, Matthew Bunyan, SumterviUe — Selma session 1893 

Cunningham, Russell McWhorter, Birmingham — Selma session. .1893 
Davis, William Ellas Brownlee, Birmingham — ^Mobile session.. 1895 

Desprez, Louis WiUoughby, Russellville — Mobile session 1895 

Duggar, Reuben Henry, Gallion — ^Montgomery session 1892 

Frazer, Tucker Henderson, Mobile — ^Mobile session 1895 

Gay, Samuel Gilbert, Selma — Selma session 1893 

Harper, Robert Franklin, Ozark — Birmingham session 1894 

Harrison, William Groce, Talladega — Montgomery session 1896 

Heflin, Wyatt, Birmingham — Selma session 1893 

Hill, George Armstrong, Wynette — ^Birmingham session 1894 

Hunter, Henry Mitchell, Uni<m Springs — Selma session 1893 

Howie, James Augustus, Jordan — Mobile session 1895 

Jones, Julius, Rockford — Montgomery session 1896 

Johnston, Louis William, Tuskegee — ^Mobile session 1895 

King, Goldsby, Selma — Selma session 1893 

McCanta, Robert Beall, Demopolis — Selma session 1893 

McLaughlin, James Madison, SprlngviUe — Birmingham session. .1894 
Moody, Henry Altamont, Bailey Springs — Birmingham session. .1894 



/ 
/ 



I 



TBB ROLL OF THE COLLEGE COUNSELLORB. 233 

Moon, William Henry, Qood water — Selma seseion 1893 

Parke, Thomas Duke, Birmingham — Selma session 1893 

Perry, Henry Oaither, Oreenvllle — Birmingham session 1894 

Quin, William Everett, Fort Payne — ^Birmingham session 1894 

Riggs, Edward Powell, Birmingham — ^Birmingham session 1894 

Robinson, Thomas Franklin, Bessemer — Montgomery session 1896 

Sutton, Robert Lee, OrrviUe— Mobile session 1895 

Swann, Joseph Charles, Wedowee — Mobile session 1895 

Williams, John Harford, Columbiana — Birmingham session.. ..1894 

Waller, George Piatt, Montgomery — ^Montgomery session 1896 

Watkins, Isaac LAFayette, Montgomery — Selma session 1893 

Whitfield, Bryan Watkins, Demopolis — ^Montgomery session... .1892 

Whitfield, James Bryan, Demopolis, Montgomery session 1896 

Wilkinson, John Edward, Prattyille — Montgomery session 1892 

Total, 38. 

THE JUNIOR COUNSELLORS. 

Ard, Erastus Byron, Osark — Montgomery session 1900 

Bancroft, Joseph Dozier, Sumterville — Mobile session 1899 

Brannon, Henry Lee, Bufaula — Selma session 1897 

Bennett, Benjamin Franklin, Clayton — ^Birmingham session. .. .1898 

Dixon, John, Fayetteville — Selma session 1897 

Dryer, Thomas Edmund, HuntsviUe — Birmingham session 1898 

Gaston, Joseph Lucius, Montgomery — Mobile session 1899 

Green, Henry Boiling, Dothan — Montgomery session 1900 

Guice, Charles Lee, Gadsden — Mobile session 1899 

Harlan, Aaron LaFayette, Alexander City — Birmingham session. 1898 

Henderson, Stephen Cory, Brewton — Mobile session 1899 

Henley, Albert Thomas, Birmingham — ^Birmingham session. .. .1898 
Hill, Robert Sommerville, Montgomery — Birmingham session . . . 1898 

Jones, Eli Spears, Gadsden — Selma session 1897 

Justice, Robert Lee, Geneva — Montgomery session 1900 

Justice, Oscar Suttle, Wetumpka — Mobile session 1899 

Lawrence, William John Dougherty, Turkeytown — ^Montgom- 
ery session 1900 

Maples, William Caswell, Scottsboro — ^Montgomery session 1900 

McCain, William Jasper, Livingston — Birmingham session 1898 

McEachem, John Adolphus, Brundidge — Selma session 1897 

Pearson, Benjamin Rush, Montgomery — Birmingham session. ..1898 

Pride, William Thomas, Madison — Mobile session 1899 

Robertson, William Henry, Clayton — ^Montgomery session 1900 

Sims, Albert Gallatin, Renfro — Birmingham session 1898 

Tam, Silas Springer, Mobile — ^Montgomery session 1900 

Thigpen, Charles Alston, Montgomery — ^Montgomery session. . . .1900 



234 ^^^ MEDICAL A8B0CIATI0N OF ALABAMA, 

Welch, Samuel Wallace, Talladega — ^Mobile session 1899 

Wyman, Benjamin Leon, Birmingham — Selma session 1897 

Total, 28. 

THB COUNSBLLORS ELECT. 

Appleton, Hugh Lowndes, Centre, Cherokee county. 
Casey, Thaddeus Alonzo, AlbertviUe, Marshall county. 
Fleming, Porter Thomas, Enterprise, Coffee county. 
Howell, John Robert Graves, Dothan, Henry county. 
Jones, Thomas Warburton, Camden, Wilcox county. 
Simms, Benjamin Britt, Talladega, Talladega county. 
Somerville, William Qlassell, Tuscaloosa, Tuscaloosa county. 
Total, 7. 

SUMMART. 

Orand Senior Life Counsellors 21 

Grand Senior Counsellors 28 

Senior Counsellors 38 

Junior Counsellors 28 

Counsellors-Elect 7 



Active Counsellors 122 



TBB ROLL OF THE COUNBBLLOBB BY DIBTRWTB. 235 

THE ROLL OF THE COLLEGE OF COUNSELLORS 
BY CONGRESSIONAL DISTRICTS. 



[On thle roll the namet of Grand Senior Life Counsel] ors do not appear.] 

On this roll the names of the counsellors are given by congressional 
districts. It Is Intended to serve as a guide In the election of new 
counsellors, with a view to the distribution of them In approximate 
proportion to the number of members In the several districts. It is 
not considered to be good policy, and It is not considered to be fair 
and right, to give a few large towns greatly more than their pro rata 
share of counsellors. The calculations are based on the nearest 
whole numbers. 

THE FIBST DISTBICT. 

Names of Counaellors. — ^E. D. Bondurant, T. H. Frazer, R. Ooode, 
H. T. Inge, E. L. Mar^chal, R. B. McCants, W. H. Sledge, B. W. 
Whitfield, J. B. Whitfield, S. S. Tam, 

Choctaw, members 10 counsellors 

Clarke, " 19 " 

Marengo, " 18 " 3 

Mobile. " 42 " 7 

Monroe, " 13 " 

Washington " 8 " 



Totals 110 10 

One counsellor to every nine members. 

THE SECOND DISTRICT. 



Names of Coufuellors. — G. Andrews, B. J. Baldwin, S. Bragg, 
L. L. Hill, R. S. Hill, A. Jay, J. A. McEachem, S. C. Henderson, 
J. L. Gaston, T. W. Jones, J. C. Kendrlck, B. R. Pearson, C. A. 
Thlgpen, G. P. Waller, I. L. Watkins, W. M. Wllkerson. 

Baldwin, members 7 counsellors 

Butler, " 14 

Conecuh, " 16 

Covington, " 6 

Crenshaw, " 17 

Escambia, " 11 

Montgomery, " 53 

Pike, " 15 

Wilcox, " 29 



2 

1 





1 

11 

, 1 

. 1 



Totals 167 17 

One counsellor to every nine members. 



236 ^^^ MEDICAL ASaOCIATION OF ALABAMA. 

THK THIBD DI8TBICT. 

Names of Counsellori. — ^EL B. Ard, B. F. Bennett, H. L. Bran- 
non» P. T. Fleming, C. H. Franklin, R. F. Harper, H. M. Hunter, 
R. L. Justice, J. R. G. Howell, W. H. Robertson. 

Barbour, members 20 counsellors 3 

Bullock, " 20 " 2 

Coffee. " 12 " 1 

Dale, " 14 •* 2 

Geneva, " 23 " 1 

Henry, " 28 " 1 

Lee, " 12 " 

Russell, " 12 " 



Totals 136 10 

One counsellor to every fifteen members. 

THE rOUBTH 0I6TBCCT. 

Names of Counsellors. — ^W. H. Bell, J. Dixon, 8. G. Gay, W. 
G. Harrison, G. A. Hill, G. King, A. G. Sims, B. B. Simms, R. L. 
Sutton, J. H. Williams, S. W. Welch. 
Calhoun, members 19 counsellors 1 



Chilton, " 11 

Cleburne, " 14 

Dallas, " 30 

Shelby, " 16 

Talladega, " 22 





3 

7 



Totals 112 11 

One counsellor to every eleven members. 

THE FIFTH DIBTSIOT. 

Names of Counsellors, — ^A. J. Coley, J. A. Goggans, A. L. Har- 
lan, J. J. Harlan, J. A. Howie, L. W. Johnston, J. Jones, W. H. 
Moon, A. J. Nolen, J. C. Swann, P. G. Trent, J. B. Wilkerson, O. 
S. Justice. 

Autauga, members 9 counsellors 1 

Chambers, " 14 " 

Clay, " 16 " 

Coosa, " 11 " 2 

Elmore, " 16 " 2 

Lowndes, " 15 " 

Macon, " 10 " 1 

Randolph, " 16 



« 



<l QA <• 



Tallapoosa, " 24 



Totals 129 18 

One oounsellor to every fourteen members. 



THE ROLL OF THE OOUNBELLOBB BY DISTRICTS. 237 



Names of OounaellorB, — J. D. Bancroft, D. S. Brockway, M. 
B. Cameron, T. P. DeWeese, J. A. Goodwin, W. J. MeCain, R. J. 
Redden, J. T. Searcy, W. G. Somerville, A. M. Stoyall. 

Fayette, members. 11 counaellora 

Greene, " 16 " 

Lamar, " 10 " 1 

Marlon, " 14 " 

Pickens. " 9 " 

Bumter, " 15 " 4 

Tuscaloosa, " 22 " 2 

Walker, " 17 " 8 



Totals 114 10 

One counsellor to every fourteen members. 

THE SZVBNTH DISTRICT. 

Names of Counaetlort — ^H. L. Appleton, T. A. Casey, L. W. Des- 
prez, B. S. Jones, J. M. McLaughlin, C. L. Guice, W. J. D. Law- 
rence. 

Cherokee, members 7 counsellors 1 

Cullman, " 14 " 

DeKalb. " 14 " 1 

Etowah, " 16 " 3 

Franklin, " 17 " 1 

Marshall, " 12 " 

St. Clair " 18 " 1 

Winston, " 5 " 



Totals 103 7 

One counsellor to every thirteen members. 

THK KIQHTH DI8TBICT. 

Names of OaunselJors—'W . H. Blake, T. B. Dryer, S. H. Low- 
ry, W. C. Maples, H. A. Moody, W. T. Pride, W. C. Wheeler. 

Colbert, members 12 counsellors 1 

Jackson, " 10 " 1 

Lauderdale, " 10 " 1 

Lawrence, " 14 " 

Limestone, " 15 " 

Bladison, " 28 " 4 

Morgan, " 12 " 



Totals 110.. 

One counsellor to every ten members. 



238 ^^^ MEDICAL ASSOCIATION OF ALABAMA. 

THE If nrTH DIBTKICT. 

Names of Counsellors — G. S. Brown, R. M. Cunningham, W. 
E. B. Davis, R. H. Duggar, W. Heflln, A. T. Henley, J. Hugglns, 
J. C. LeGrand, T. D. Parke, H. O. Perry, B. P. Riggs, T. P. 
Robinson, L. Whaiey, C. A. Wllkerson, B. L. Wyman. 

Bibb, members 19 counsellors 1 

Blount, " 9 " 

Hale, " 17 " 4 

Jefferson, " 120.. " 9 

Perry, " 12 " 1 



Totals 177 15 

One counsellor for every eight members. 

GENERAL BUMMABY. 

The whole number of members in the state is 1,158, and the 
whole number of counsellors, exclusive of Grand Senior Life Coun- 
sellors, is 100. This gives one counsellor to every 11.68 members. 
For convenience, we say one counsellor for every eleven members, 
about. 

The first district, with 110 members, and 10 counsellors, has 
the number to which it is entitled. 

The second district, with 167 members, and 16 counsellors, has 
one counsellor less than it is entitled to. 

The third district, with 136 members, and 10 counsellors, has 
two counsellors less than it is entitled to. 

The fourth district, with 112 members, and 12 counsellors, has 
two counsellors less than it is' entitled to. 

The fifth district, with 129 members, and 13 counsellors, has 
five counsellors more than it is entitled to. 

The sixth district, with 114 members and 10 counsellors, has 
the proper number it is entitled to. 

The seventh district, with 103 members, and 7 counsellors, has 
two counsellors less than it is entitled to. 

The eighth district, with 110 members, and 7 counsellors, has 
three counsellors less than it is entitled to. 

The ninth district, with 177 members, and 15 counsellors, has 
one counsellor less than it is entitled to. 



THE ROLL OF OFFIOBRS. 239 



ROLL OF CORRESPONDENTS. 
Revision of 1901. 



Bozeman, Nathan, M. D., New York 1899 

Fletcher, R. M. Jr., M. D., Fort Harrison, Mont 1900 

Gamett, A. S., M. D., Hot Springs, Ark 1875 

Hoffman, John R., M. D., Athens, Ala 1890 

Mitchell, William A., M. D., Eufaula, Ala 1891 

Moses, Qratz A., M. D., St Louis, Mo 1874 

Osborne, Thomas C, M. D., Claiborne, Texas 1885 

Peavy, Julius F., M. D., Ashville, N. C 1899 

Rorex, James Polk, M. D., Scottsboro, Ala 1891 



THE ROLL OF OFFICERS. 
Revision of 1901. 



PRESIDENT: 
Edwin Lesley Mabechai., M. D Mobile. 

VICE-PRESIDENTS: 

Senior — ^William T. Pbide, M. D Madison. 

Junior — Matthew Buntan Camebon, M. D Sumterville. 

SECRETARY: 

Geobge Platt Waller, M. D Montgomery. 

(Term expires 1903.) 

TREASURER: 

Henbt Oaitheb Pebbt, M. D Montgomery 

(Term expires 1903.) 

The State Boabo of Censobs, Acting as a State Boabd of Medical 
Examinees, and as a State Ck)MMmEE of Public Health. 

Franklin, Charles Higgs, Union Springs 1901-1906 

Wilkerson, Wooten Moore, Montgomery 1901-1906 

Robertson, Thaddeus Lindley, Birmingham 1900-1905 

Oaines, Vivian Pendleton, Mobile 1900-1905 

ShoU, Edward Henry, Birmingham 1899-1904 

Andrews, Glenn, Montgomery 1899-1904 

Searcy, James Thomas, Tuscaloosa 1899-1903 



240 ^^^ MEDIOAL ASSOCIATION OF ALABAMA. 

Furniss, John Perkins, Selma 1898>1903 

Sanders, William Henry, (Senior Censor), Mobile 1897-1902 

Moody, Henry Altamont, Bailey Springs, (unexpired 

term) 1897-1902 

ORATOR: 
Edward Bubton Ward, M. D Selma. 

ALTERNATE ORATOR: 
Lewis Coleman Morris, M. D Birmingham. 

MONITOR: 
Jacob Huoams, M. D Newbeme. 

HISTORIAN: 
Samuel Wallace Welch, M. D Alpine. 

JEROME COCHRAN LECTURER: 
John H. Musseb, M. D ...Philadelphia, Pa. 

STATE HEALTH OFFICER: 

William Henrt Sanders, M. D Mobile. 

(Official residence, Montgomery.) 
(Term expires 1904.) 

PLACE OF MEETINGS- BIRMINGHAM. 
Time of Meeting, Third Tuesday In April, 1902. 



SCHEDULE OP REGULAR REPORTERS. 

SESSION OF 1901. 



(1) Glenn Andrews, M. D., Montgomery, Ala. — 

What Precautions Should be Taken to Prevent the Spread 
of Infectious Diseases? 

(2) William L. Dinsmore, M. D., Decatur, Ala. — 

Uric Acid, a Factor in Disease (causation. 

(3) T. Joseph Dean, M. D., Union Springs, Ala. — 

The Medicine and Surgery of the Future, from the 
Standpoint of Sanitation and Prevention. 

(4) William Gboce Habbison, M. D., Talladega, Ala. — 

Pneumonia, With Special Reference to Complications and 
Treatment. 



BOHBDULS OF RB&ULA9 RBPOBTERS. 241 

(6) A. L. Hablan, M. D., Alexander City, Ala. — 

La Grippe In Alabama; Its Oomplleations, Sequelae, and 
Treatment. 

(6) Hon. J. B. Dukei LaFayette, Ala. — 

The Relation of the Medical and Legal Professions. 

(7) L. L. Hill, M. D., Montgomery, Ala. — 

Cholelithiasis, with a Report of Cases. 

(8) William R. Jackson, M. D., Mobile, Ala. — 

Surgical Feyers. 

(9) William H. HTn>BON, M. D., LaFayette, Ala. — 

Recent Progress in Brain Surgery. 

(10) S. C. Henderson, M. D., Brewton, Ala. — 

Recent Progress in Our Knowledge of Malaria. 

(11) F. Goodwin DuBose, M. D., Selma, Ala. — 

Cancer of the Breast, With Special Reference to the 
Treatment of Inoperable Cases. 

(12) Robebt D. Jaokson, M. D., Woodlawn, Ala. — 

The Medical Treatment of Old Age. 

(13) Wtatt Hetun, M. D., Birmingham, Ala. — 

Bctopic Gestation. 

(14) J. B. KiLLABSEW, M. D., Mobile, Ala. — 

The Toxaemia of Pregnancy. 

(16) William J. McCain, M. D., Livingston, Ala. — 
Haemorrhagic Malarial Fever. 

(16) Robebt J. Redden, M. D., Sulllgent, Ala. — 

The General Practitioner as a Gynecologist. 

(17) Bdgab a. Jones, M. D., Birmingham, Ala. — 

The Relation of the State to Tuberculosis. 

(18) O. L. Shivebs, M. D., Marion, Ala. — 

Mastitis. 

(19) Thomas D. Pabke, M. D., Birmingham, Ala. — 

What is the Cause of the Large Infantile Mortality in 
Alabama, and How can it be Obviated? 

(20) J. D. S. Davis, M. D., Birmingham, Ala. — 

Api>endicitls. 

16 



242 ^^^ MEDICAL AB80CIATI0N OF ALABAMA. 

SCHEDULE OF THE ANNUAL SESSIONS AND 
PRESIDENTS SINCE THE RE-ORGANI- 

ZATION IN 1868. 



Selma— Albert Gallatin Mabry 1868 

Mobile— Albert QallaUn Mabry 1869 

Montgomery — ^Richard Frazer Michel 1870 

Mobile — Francis Armstrong Robs 1871 

HuntSYille— Thomas Childress Osbom 1872 

Tuscaloosa — George Earnest Kumpd 1873 

Selma — George Augustus Ketchum 1874 

Montgomery — ^Job Sobieski Weatherly 1875 

Mobile — John Jefferson Dement 1876 

Birmingham — ^Edward Davles McDaniel 1877 

Eufaula — Peter Bryce 1878 

Selma— Robert Dickens Webb 1879 

HuntSYille — Edmund Pendleton Gaines 1880 

Montgomery — ^William Henry Anderson 1881 

Mobile — John Brown Gaston 1882 

Birmingham— Clifford Daniel Parke 1883 

Selma — Mortimer Harvey Jordan 1884 

Greenville — Benjamin Hogan Riggs 1885 

Anniston — Francis Marion Peterson 1886 

Tuscaloosa — Samuel Dibble Seelye 1887 

Montgomery — Edward Henry Sholl 1888 

Mobile— Milton Columbus Baldrldge 1889 

Birmingham — Charles Higgs Franklin 1890 

Huntsville— William Henry Sanders 1891 

Montgomery — Benjamin James Baldwin 1892 

Selma — ^James Thomas Searcy 1893 

Birmingham — ^Thaddeus Lindley Robertson 1894 

Mobile — Richard Matthew Fletcher 1895 

Montgomery — ^William Henry Johnston 1896 

Selma— Barckley Wallace Toole :.1897 

Birmingham — ^Luther Leonidas Hill 1898 

Mobile — ^Henry Altamont Moody 1899 

Montgomery — ^John Clark LeGrand 1900 

Selma — ^Russell McWhorter Cunningham ,.,,.,.., 1901 



THE SCHEDULE OF THE ANNUAL ORATORS. 243 



THE SCHEDULE OF THE ANNUAL ORATORS. 



Gaston, John Brown — ^Mobile session 1869 

Ketchum, George Augustus — ^Montgomery session 1870 

Anderson, William Henry — ^Mobile session 1871 

Weatherly, Job Sobieskl — ^Montgomery session 1872 

Jordan, Mortimer Harvey — ^Tuscaloosa session 1873 

Seelye, Samuel Dibble — Selma session 1874 

Ketchum, George Augustus — ^Montgomery session 1875 

Michel, Richard Frazier— Mobile session. 1876 

Foumler, Edmund Henry — ^Birmingham session 1877 

Riggs, Benjamin Hogan — ^Bufaula session 1878 

Mitchell, William Augustus — Selma session 1879 

Baker, Paul DeLacy — ^Huntsyille session 1880 

Baldrldge, Milton Columbus — ^Montgomery session 1881 

Bryce, Peter — ^Mobile session 1882 

Shell, Edward Henry — ^Birmingham session 1883 

Sanders, William Henry — Selma session 1884 

Searcy, James Thomas — Greenville session 1885 

No oration delivered — Annlston session 1886 

Huger, Richard Proctor — Tuscaloosa session 1887 

Baldwin, Benjamin James — ^Montgomery session 1888 

Coleman, Ruflln — Mobile session 1889 

Inge, Henry Tutwller — Birmingham session 1890 

Riggs, Edward Powell — ^Huntsvllle session 1891 

Wyman, Benjamin Leon — ^Montgomery session 1892 

Andrews, Glenn — Selma session 1893 

Blake, Wyatt Heflin — ^Birmingham session 1894 

Cunningham, Russell McWhorter — Mobile session 1895 

Mar6dhal, Edwin Lesley — ^Montgomery session 1896 

Hill, Robert Sommerville — Selma session 1897 

Harper, William Wade — ^Birmingham session 1898 

Chapman, George Clarence — ^Mobile session 1899 

Goode, Rhett — ^Montgomery session 1900 

Harrison, William Groce — Selma session 1901 



244 3'J7« MBDIOAL ASBOOIATIOir Of ALABAMA. 



OBITUARY RECORD. 



[Taken from Reports of the Secretaries of C!ounty Medioal Societies.] 



I 



Autauga County — Charles Alva Edwards, mc Memphis 49, cb 80, 
Prattville. Date and cause of death not stated. 

Barboub County — ^Albert Goodwin, mc Louisville 73, cb 79, Eufaula. 
C. H. McDonald, mc Alabama 1900, Clio. Dates and causes 
of death not stated. 

Bibb County — Jacob Usry Ray, Sr., old law 69, cb Tuscaloosa 82. 
Woodstock. John Wesley Jones, mc , cb — . Ran- 
dolph. Dates and causes of death not stated. 

Blount County — ^William Kings Clapp, old law. Gum Springs. Date 
and cause of death not stated. 

Bullock County — ^Augustus Clayton Crymes, mc Jefterson 56, cb 80, 
Midway. William Bartlett Thomasson, mc Georgia 64, cb 80. 
Aberfoll. Dates and causes of death not stated. 

Butlbb County — ^William Paners Grissett, mc 72, cb Monroe 

84. Garland. Cause of death, consumption. Date of death, 
not stated. 

Calhoun County — Frederick Woodhull Buckalew, mc univ Grant 
93, cb 96. DeArmanyille. Phillip Pleasant Linder, cb 81. 
Jacksonville, C. C. McClintock. Dates and causes of death, 
not stated. 

Chkboksb County — C. Story, cb 86. Key. Cause of death, drowning. 

Choctaw County — Ferdinand Pajrne Clarke, mc Alabama 84, cb Ma- 
rengo 84. Bevllle. Died in September, 1900. Cause of 
death, not stated. William P. Kimbrough, mc Alabama. 
Pushmataha. Date and cause of death not stated. 

Coosa County — ^William J. Peddy, mc Graffenburg 66, cb 83. Rock- 
ford. Died of valvular disease of heart in October, 1900. 4> 
Age, 69. 

Cullman County— W. A. McDonald, mc Georgia Reform 69, cb 89. 
Baileyton. Date and cause of death not stated. 

Dallas County — John Alexander McKinnon, mc univ Louisiana 67, 
cb 78. Selma. Died of nephritis. Date not given. Kenneth 
McKinnon, mc univ Louisiana 49, cb 78. Pleasant Hill. Date 
and cause of death not stated. John Alonzo Weissinger, 
mc Alabama 98, cb 98. Talmage. Cause of death, tubercu- 
losis. Date not given. 



TBB OBITUARY RECORD. 245 

DxKalb Ck>uifTT— William Jonee Wooten, cb 89. Musgrove. Date 
and cause of death not stated. 

Blmobb CotTiffTT — ^Robert McCullough Hill, mc Alabama 94, cb 96. 
Ware. Cauee of death, remittent fever. Date not given. 

Hale County — Thomas Franklin Moore, mc Alabama, 91, cb Bl- 
more 92. Stewarts. Died of acute dysentery in Decem- 
ber, 1900. James Adams Tidmore, mc unlv Kansas City 
84, cb 89. Havana. Died of pneumonia in November, 1900. 

Henby County — Fleming Isaac Moody, mc phys and surg Baltimore 
76, cb 83. Dothan. Cause of death, pneumonia. Date not 
given. 

Jackson County — T. H. Helton, cb 82. CafTey's Store. Cause of 
death, pneumonia. Date not given. Green Pryor McAfFee, 
cb 82. Line Rock. Date and cause of death not given. 

jEmcBsoN County — John Gardiner Griggs, mc unlv Pennsylvania 
63, cb Macon 86. Birmingham. Died of apoplexy in Octo- 
ber, 1900. George Clarence Chapman, mc imiv Vanderbllt 
90, cb Monroe 90. Birmingham. Killed by tornado, March 
29, 1901. 

Laudeboale County — ^William Epps Hardaway, mc univ Nashville 
66, cb 87. Florence. Date and cause of death not given. 

Lowndes County — ^Abraham Cruzer McRea, mc univ Pennsylvania 

60, cb 78. Lowndesboro. Samuel Taylor Peake, mc imiv 

Vanderbllt 83, cb 83. Benton. Edwin Lewis Sanderson, mc 

Jefferson 67, cb 78. Letohatchie. Dates and causes of 

death not stated. 

Maoon County — William Alexander Reynolds, mc South Carolina 
62, cb 79. Warrior Stand. Died January 11, 1901. Cause 
of death not stated. John Sistrunk, mc univ New York 69» 
cb 79. Society Hill. Date and cause of death not given. 

Madison County— William G. McKelvey, cb 88. Dallas Mills. Died 
in February, 1901, of suppurative hepatitis. Anthony Na- 
talie Glover, mc univ Nashville 87, cb 87. Owens Cross 
Road. Date and cause of death not stated.' 

Mabbngo County — ^Edmond Strudwick, mc JefTerson 67, cb 78. Day- 
ton. Died of la grippe. May, 1900. 

Mabshall County— William M. Scarborough, cb Clay 87. Albert- 
ville. Date and cause of death not stated. 



246 ^^^ MEDICAL ASaOOlATION OF ALABAMA. 

Mobile Oovvn — ^Milea Bdward McCarty, mc Alabama 78, cb 78. 
Whistler. Date and cause of death not stated. 

MoNTOOMEBT Ck)UNTT — ^Jesse Holmes Naftel, mc Alabama 87, cb 87. 
Montgomery. Thomas Alexander Means, mc Atlanta 67, cb 
78. Montgomery. Dates and causes of death not stated. 

Pickens Ck)UNTT — Samuel Johnston Sterling, mc Alabama 61, cb 78. 
Olney. Cause of death paralysis. Date not given. James 
Francis Bamett, mc Alabama 92, cb 92. Temple. Cause of 
death, angina pectoris. Date not given. Thomas Harlan Mc- 
Kinstry, mc Alabama 93, cb 93. CarroUton. Cause of death, 
pneumonia. Date not given. 

Randolph CouNTT-r-Michael M. McManus, cb 79. Lamar. Cause 
of death, cerebral Traumatism. Date not given. 

Tuscaloosa County — ^Alsey Clements, cb 78. Vance. Date and 
cause of death not stated. 



THE APPENDIX 

OP THE 

Medical and Sanitary Dissertations 

AND REPORTS. 



THE ANNUAL ORATION. 



Bt William Orocb Habbison, M. D., Talladega. 
Junior Counsellor of the Medical Association of the State of 

Alabama. 



In the selection of a theme for this occasion^ I am lim- 
ited by certain well defined boundaries that one dares 
not over-leap. I am bounded on the North by a statute 
of our Constitution which requires that the "Annual 
Oration" shall be on a subject of mutual interest to the 
general public and Medical Profession ; bounded on the 
East by the fact that thirty-one orations have preceded 
this occasion and have well nigh exhausted the more 
popular topics ; I am bounded on the South by the fear 
and danger of being considered personal in my allu- 
sions ; last and greatest, I am bounded on the West, and 
on all aides "by the lamentable fact that I have no gift 
of oratory. Eight years ago it was the fortune of Dr. 
Glenn Andrews to address a Selma audience on a simi- 
lar occasion. After searching the broad field for a 
suitable subject he selected drinking water, and, if mem- 
ory fails not, you will recall how well he treated the 
theme. When all was over he is said to have been griev- 
ously disappointed to learn that water had scarcely 
been introduced into Selma as a beverage and was little 
known except to the clergy and a few of Mrs. Nation's 
followers. I give this as mere rumor. If the real facts 
were demonstrated, it might transpire that the accom- 
plished orator didn't recognize water when he saw it. 



248 ^^^ AI^NUAL ORATION. 

Mr. Moody was accustomed to say that his audiences 
were distributive hearers. I naturally assume this one 
to possess a similar accomplishment. 

In his humorous lecture^ ^'Boasted Husbands on 
Toast/' Dr. Edwin Hall was wise enough to specify every 
disparaging remark as applying to people in far away 
Alaska^ and thus he escapes the aspersion of personali- 
ties to his audience. 

With your permitasion, I shall speak of certain 
"Phases of Intemperance and their Relation to the Medi- 
cal Profession." 

In the popular mind^ the word "Intemperance** enjoys 
the limited meaning — "habitual or excessive indulgence 
in alcoholic liquors . " 

Tonight we employ it in that broader sense as de- 
fined by Webster, "Any immoderate indulgence of appe- 
tites or passions." 

Estimating that the population of the entire world is 
one and a half billion^ and the average human life is for- 
ty years, we can easily calculate that the average death 
rate for every minute both day and night is about seven- 
ty-two. Of this number one person dies every five sec- 
onds from some form of consumption. You will be sur- 
prised to hear — but it can be easily proven — that the 
various forms of intemperance destroy more than twice 
that number. I pause to emphasize that one individual 
must perish every three seconds from one or the other 
kinds of intemperance. Every nation has its special 
beverage, every township has its well known gourmand 
and I might say almost every family has a representa- 
tive whose mind is clouded, health impaired, life short- 
ened, by some form of excess. Intemperance respects 
neither caste nor creed. The helpless infant at its moth- 
er's breast, the sweet maiden just blushing into beauty, 
the man of forty-five bearing the burdens of life, and even 
tottering age, are all alike subject to this masterful i>as- 
sion. 

Invading the princely palace, creeping through the 
half closed door of poverty's hovel, crossing the thresh- 
hold of our best statesmen and claiming its adherents 
from pulpit and forum, it over-strides all bounds of pro- 
priety and even infests "My Lady's Boudoir," to de- 
stroy domestic happiness and lay a predicate for enfeeb- 
ling the vitality of another generation. 



\ 



-!■■■■ 



WILLIAM GROOE SAJtBISON. 249 

Moderation is the balance wheel of lif e, it is the hand- 
maid of health — the veritable guardian of domestic joy, 
the essential essence of national peace. Excess is the in- 
stigator of discord and discontent, the attendant of 
want and woe, the escort of disease and death. 

One kind of excess which afflicts most communities, 
outside of Dallas County, is intemperate speech. Be- 
ginning as a good natured jester, most innocent at first, 
the intemperate talker rapidly passes to the stage of gos- 
sip ; from here 'tis but a step to slander and this is one 
of the most baneful and disrupting influences that can 
afflict any neighborhood — 

"At every word a reputation dies." 

It has severed the sacred bonds of life-long friendship ; 
it has broken churches into warring factions: impaii'ed 
the usefulness of ministers and destroyed the peace of 
whole communities. 

Another species of intemperance which has afflicted 
us is the insane desire for Fashion. In one of his popu- 
lar stories, Max O'Kell amusingly relates the origin and 
rapid spread of the high hand shake. 

On one occasion he had baggage strapped and ticket 
purchased to leave Paris for a*voyage to America. There 
was some kind of a fashionable entertainment in the 
public garden that night at which the members of the 
old royal family were prominent guests. 8ome enter- 
prising reporters observed a countess shake hands with 
a gentleman friend over a leaning rose bush. To accom- 
plish this feat she had to raise her hand almost to the 
level of her brow. The novelty of the act struck the re- 
porter as interesting and the following day every fash- 
ionable Parisian was seen to greet his friend with a hand- 
shake as high as his chin. Mr. O'Bell sailed on that even- 
ing and tells with much good humor how the sad good- 
byes were punctuated by this new fashion. When he 
arrived at Boston he was overwhelmed to observe that the 
enterprising Hubites had received the style by cable and 
swallowed it in toto. Mr. O'Rell was en route to Aus- 
tralia and at every stop on the continent saw evidences of 
this same blind worship. He laughingly relates that when 
he reached Samoa, Robert Louis Stevenson gave him a 
cordial greeting after the latest Parisian custom. 



mmKs,!, 



260 THE ANNUAL ORATION. 

^^I see that Fashion wears out more apparel than the 
man," said the "Bard of Avon/' — ^a solemn truth. 
Churchill exclaims : 

** Fashion — a word which knaveB and fools may use 
Their knavery and folly to excuse." 

Strange it is, we worship at this shrine though it 
strain every financial nerve. Blinded by extravagant 
passion, the devotees of style seem utterly indifferent to 
accumulating debts and increasing liabilities, until 
finally, as by a cataract, they are engulfed in bankruptcy, 
Just as the popular mind is more or less tinctured with 
superstition, so are all slaves of fashion. What other 
power could induce the fearful extremes of dress, which 
distort and deform the body of lovely woman and ren- 
der her an easy prey to many ills and pains? 

It was Cowper, the author of so many sweet and sacred 
poems, who spoke of "Cups ttiat cheer but not inebriate.'^ 
True it is, they cheer, and most rarely, if ever, do they 
intoxicate, but every physician of extensive experience 
in the handling of heart and nerve cases must recognize 
in the excessive indulgence of tea and coffee a potent 
factor in the causation of disease. Gratifying in their 
moderate use and delightful in their temporary effect, 
nevertheless, when long continued, they are capable of 
causing obstinate dyspepsia and many kinds of nerve 
disorder. The Classical "Question Mark" of English 
Literature alludes to coffee as the beverage. 



<• « • • which makes the politician wise. 
And see through all things with half shut eyes.' 



and no less a light than CoUey Cibber apostrophizes: 
"Tea! thou soft and venerable liquid, thou female tongue- 
running, smile-smoothing, and heart-opening cordial, 
to whose glorious insipidity I owe the happiest moments 
of my life." Thousands will endorse each of these au- 
thors, but a greater number suffer nervous headaches, 
when denied their cup, and the woes of dyspepsia when 
their taste is gratified. Another and no less serious 
phase of this question is the fact that young children 
accustomed to the use of these stimulants soon feel the 
need of stronger ones. 

Any discourse on Intemperance to an American as- 
semblage, would be incomplete without reference to the 



h 



WILLIAM GROOB HARRISON. 251 

"Virginia Weed . *' To mo»t of you the phrases, *tobae- 
00 throat'' and "tobacco heart" are familiar terms and 
they are an index to a much needed lesson in health 
preservation. While excess in the gratification of any 
appetite invariably tends to disaster, the moderate in- 
dulgence is a real pleasure. In "Beveries of a Bache- 
lor," that delightful collection of dreams by Marvel, he 
says, ^That first taste of the new smoke and fragrant 
leaf is very grateful, it has a bloom about it that you 
wish might last, it is like your first love — fresh, genial, 
and rapturous. Like that it fills up all the craving of 
your soul ; and the light blue wreaths of smoke, like the 
roseate clouds that hang around the morning of your 
heart-life, cut you off from the chill atmosphere of mere 
worldly companionship and make a gorgeous firmament 
for your fancies to run riot in . " 

Oh! beautiful tribute to the soothing effects of this 
universal companion. Many of you will endorse the 
recital of its joyous comforts. All this I grant, but car- 
ried to excess it possesses wonderful power for evil. The 
destructive results are in proportion to the amount used, 
the vital power of resistance, and eliminative capacity 
of each individual. This resolves itself into a personal 
equation and renders it more difficult to formulate gen- 
eral rules ; but certain it is that there is always a ten- 
dency to excess and this immoderation is invariably 
harmful. Many are the experiments performed to dis- 
prove the injurious effects of tobacco— but they have 
demonstrated the reverse of the acknowledged intention. 

Dr. J. W. Seaver, of Yale, made accurate observations 
of about two hundred college men of one class. He di- 
vided them into three groups, first, the non-users of to- 
bacco in any form ; second, those who had used it regu- 
larly for at least a year ; third, the occasional users. He 
made accurate records and demonstrated that the first 
group gained in weight lO^^more than the second and 
Gi^*' more than the third. In height the abstainers in- 
creased 24 per cent more than the habitues and 11 per 
cent more than the irregulars. In girth and chest, the 
first group increased 26 per cent more than the second 
and 22 per cent more than the third. In lung capacity 
the abstainers gained 77 per cent more than the de- 
votees and 46 per cent more than the "tipplers . " This 
is but one of many investigations — all leading to the 
same general conclusion. 



252 ^^^ ANNUAL ORATION. 

Tobacco is never of any real value to the economy find 
some times is exceedingl v. harmful. In the examination 
of applicants for admission to the army during the Span- 
ish war over 90 per cent of all those addicted to ciga- 
rettes were rejected on account of physical unfitness. 
Those accustomed to examine for life insurance com- 
panies are sadly familiar with the abnormal heart and 
contracted chest of tobacco fiends. Another serious re- 
sult of this habit is its frequent effect on future genera- 
tions. The great Sir Benjamin Brodie has said : ^^No 
evils are so manifestly visited upon the third and fourth 
generations as the evils springing from the use of to- 
bacco." We are accustomed to defend the weed by 
allusions to some octogenarian of the neighborhood who 
has constantly used it since early life, happily, so forti- 
fied by nature as to resist its injurious tendencies. But, 
study his children and their off -spring — ^make note of the 
far-sighted — the near-sighted — the astigmatic, of those 
afflicted with St. Vitus's dance, of the hysterical daugh- 
ter, and the nervous and stimulant craving grand-son. 
In nothing is temperance more becoming and necessary 
than in the use of tobacco. 

As I said before, in the popular mind, intemperance 
comprises merely the excessive use of alcohol. With 
this phase all of us are more or less familiar and on it 
I shall not long detain you. While disavowing my con- 
fidence in the drug as a food and feeling very skeptical 
of its utility as a stimulant, I shall not harangue you 
with an argument pro or con. Alcohol, like opium, is 
essentially a pain-killer — hence its universal employ- 
ment. 

Think for one moment how natural, indeed, I might 
say, how inevitable, it is that we blunder in its use. 
"Here is a man shivering with cold, we give him whisky, 
he is less conscious of cold and we at once acquiesce in 
his delusion that he is warm. The next week the same 
man is over-heated, a w^ell-meaning friend administers 
alcohol — ^his nerves are deadened — ^he is less conscious 
of heat — so, we flatter the remedy and believe the patient 
is cooling off." Another illustration : We find one who 
digests his Kansas City breakfast with distress and diffi- 
culty—we give him alcohol, he is less conscious of dis- 
comfort and naturally praises the supposed cure-all. 
However, I promised tbat only the abuse of alcohol 



WILLIAM QROOB HABRISOlf. 253 

should engage your attention. In the fiummer of '98 
an eminent authority, in touch with all the statistics of 
imi)orted beverages and familiar with the output of 
home factories, estimated that the annual consumption 
of alcoholic drinks, calculated in figures of absolute alco- 
hol, is over 1^ gallons for every individual in the United 
States. 

This man was working strictly in the interests of 
science, not employed by any temporary organization. 
Pause for once and consider this enormous excess. One 
gallon of absolute spirit for every individual in the 
Union. Without elaborating on what alcohol will not 
do for the human body, let me briefly recall some things 
that its intemperate use will unfailingly accomplish. It 
will cause the most severe acute indigestion. Long con- 
tinued, it produces the worst form of gastric catarrh, be- 
yond the power of man or medicine to cure. It is a 
prominent factor in the etiology of congestion, inflam- 
mation, and cirrhosis of the liver. Secretly and stealthily 
it saturates the system with uric acid and thereby im- 
plants a foundation for Bright's disease. It impairs the 
eye-sight and hearing, it is the most productive agent 
in the causation of nervous diseases, and over 25 per cent, 
of the insane place upon alcohol the burden of their mis- 
fortune. But, listen, the prolonged ingestion of these 
beverages wfll so impair the power of resistance — the 
power to eliminate poison and repel disease — that the 
patient succumbs to what would otherwise be a mild 
malady. 'Tis almost a curiosity to see an old alcoholic 
habitu^ recover from pneumonia or typhoid fever. Final- 
ly, we dare not disregard the appalling fact of hered- 
ity. Just as we inherit a case of consumption, a gift of 
mind, or impulse of disposition, so we inherit a weaken- 
ed resistance and a lowered vitality. It is no exception 
for one addicted to any phase of intemperance to have 
a contracted chest, feeble heart, irritable stomach, stupid 
mind, and a general tendency to excess in any indulg- 
ence. 

While roaming quietly through the moonlit gardens 
of Arcadia, Hygeia, the goddess of health, was lament- 
ing over the ills of her people, when her solitude and 
meditation were ruthlessly interrupted by the sudden 
appearance of Bacchus, the god of wine. 



264 r^^ ANNUAL ORATION. 

Said he : ^^Come drink with me, I give friends to the 
lonely, strength to the weary, and make joyous the dis- 
tressed." Said Hygeia: "Thy promises are sweet, but 
the fulfillment a delusion, the danger is no less because 
concealed beneath thy veil of pleasure." Then Bacchus 
boastingly exclaims : "Come ye sons of toil and receive 
rest, ye sluggish brains and recover fresh vigor, ye tired 
minds and receive renewed brilliancy ; come ye broken- 
hearted and accept the consolation of my potion." Then 
Hygeia, rising to full height, with the light of truth bath- 
ing her brow and the fervent glow of sincerity sparkling 
in her eyes, points the finger of scorn to guilty Bacchus, 
while she exclaims : "No ! the testimony of army officers, 
of insurance companies, of ^Arctic explorers and ahtletes 
is practically unanimous that the total abstainers bear 
extremes of heat and cold, endure sharp confiicts and 
long marches, exposure to storm and disease much bet- 
ter, and recover from fatigue and illness more speedily,' 
than those who bounteously or sparingly partake of the 
flowing bowl. Oh ! Bacchus, thou hypocrite, no longer 
deceive us, thy claim is false, thy end is death. " 

As a physician of less than ten years' experience in 
general practice, you will not grant me credit for such 
extensive observations as some of my older and wiser col- 
leagues who help to comprise this audience, but I ven- 
ture they will sustain me in the assertion that the aver- 
age adult in Alabama is extremely intemperate in drug 
taking. 

Less than six months ago I was called to see the baby 
of most affectionate parents. Upon diligent inquiry as 
to the cause of the disease I was informed that the in- 
fant had enjoyed nothing unusual in diet except some 
orange juice, twenty-four hours previously, since which 
time he had been very ill. The mother had given assaf(B- 
tida, soothing syrup, and teething powders, with disap- 
pointing results. The father was called in consultation, 
immediately understood the situation, and begun 
"broken doses of calomel." Finding no abatement in 
several hours, they conferred with the grandmother, who 
forthwith advised a decoction of egg shell and had the 
chest well covered with equal parts of kerosene and 
mutton suet. Poor little sufferer ! A half teaspoonf ul 



WILLIAM GROOB HARRISON. 255 

of sypup of ipecac prescri'bed by myself brought away 
the offending orange seed, and all was well. 

A few years ago, I knew a man to swallow within a 
half hours' time the contents of eleven eight-ounce bot- 
tles of Dr. "Somebody's Favorite Prescription," or 
"New Discovery," without feeling the least discomfort. 
Pity it is that all popular remedies are not equally in- 
nocent ! Alas ! too many but start the insatiable thirst 
for stronger drugs, 'till overwhelmed in the maelstrom 
of excess and intemperance. 

Some months ago a prominent commercial traveler 
representing one oif the largest firms in the Union called 
my attention to his enormous sales of cocaine and mor- 
phine. Prompted by this, I wrote some twenty or more 
wholesale drug houses and above fifty of the representa- 
tive retail druggists of Alabama, requesting an estimate 
of the per cent, of increase in their sales of these two 
medicines. Over half of the number responded, and 
from these I get the average increase in the 
sales of morphine to be above 35 per cent, in ten years, 
and of cocaine over 75 per cent. One large wholesale 
house writes that its general business has increased 30 
per cent, in five years, while its sales of cocaine have 
increased over 2,000 per cent. They uniformly state that 
a large proportion of these drugs is bought by the gen- 
eral public. 

The enormity of damage resulting from the indis- 
criminate sale and intemperate use of cocaine is 
almost beyond conception. As a snuff, it is becom- 
ing popular among out Southern negroes, and ere 
long we may expect a most pitiful spectacle — when 
they have neither shelter nor food, but are mad- 
ly craving the expensive drug and thereby rendered 
unable to work; then, indeed, will they be given up to 
riotous excess, and debauchery of every kind. In one of 
his thrilling stories, Dr. Conan Doyle makes his famous 
detective, Sherlock Holmes, resort to the use of cocaine 
to stimulate his mind to a high degree, 'ere he could fer- 
ret out those finely-spun detective schemes, and I regret 
to say it has become the habit of some a^^tors, public en- 
tertainers, and others to use the same drug to quicken 
their wit and sharpen their perception. The temporary 
effect is gratifying — ^the end is change of character, dis- 
ease, lost will, dishonesty, impaired nerve energy, disre- 



256 rJTJP ANNUAL ORATION. 

gard of truth, insanity, and, often, death. Cocaine is now 
taken by a comparatively few, but the habit is most 
rapidly spreading. 

It is claimed that opium is used to excess by six or 
eight per cent, of the entire x)opulation. It is one of 
God's best gifts to suffering humanity, but like His other 
gifts, when used in excess it becomes the vilest curse. 
While necessary in many conditions, opium always has 
the properties of a jwwerful poison and should never be 
used except when ordered by one thoroughly familiar 
with its nature. 

"The inveterate opium habitu^ is, notoriously, always 
under an opium dream as to the harmlessness or even 
benefit of his habit. From such persons much of the 
testimony in favor of opium has clearly come." As an 
index to the amount of opium and of its various deriva- 
tives used in some localities in our State, I will quote 
from certain of the letters above referred to. In one 
town of about 1,000 population, the druggist writes he 
sells about 50 quarts of laudanum — twelve and a half 
gallons — and over forty ounces of morphine. Not one- 
tenth of this is sold to, or ordered by, physicians. As- 
suming that he supplied 1,000 people in the surrounding 
country in addition to his towns people, this means he 
sold 26 full doses of laudanum and 34 full doses of mor- 
phine to each individual in his neighborhood. 

A drummer from one house told me that his yearly 
sale of morphine in a certain Mississippi town would 
average ten ounces for each 1,000 of population. When 
we calculate this we find one house selling over twenty 
full adult doses of morphine for each individual in the 
community. This man expressed a doubt that he had 
sold even a fourth of the morphine consumed at that 
place. I could tell you a dozen similar cases. 

In one of his excellent medical pictures, Crabbe uses 
this graphic recital of the dangers to which the "little 
waves on the sea of life" are subjected : 

Then the good nurse, (who had she borne a brain 
Had sought the cause which made the babe complain) 
Has all her efforts, loving soul applied, 
To set the cry and not Uie cause aside. 
She gave her powerful sweet without remorse; 
The sleeping cordial — she has tried its force. 
Repeating oft, the infant freed f h>m pain, 
Rejeoted food, but took the dose again. 
Sinking to a sleep, while she her joy expressed. 
That her dear charge should sweetly take its rest; 
Soon may she spare her cordial — not a doubt 
Remains, but quickly he wiU rest without. 



WILLIAM QROCB HARRISON. 267 

None can tell the effects of opium so forcibly and elo- 
quently as he who has used it in excess, as was done in 
that classical monograph, ^^Confessions of an English 
Opium Eater.'* Thomas DeQuincey gives a clear ex- 
position of its power and danger. After one day's ab- 
stinence, he gratified his longing and thus he exclaims : 
"I took it and in an hour, Oh, heavens ! what a revulsion ! 
What an upheaving from the lowest depths of the inner 
spirit! What an ai)ocalypse of the world within me! 
That my pains had vanished, was now a trifle in my eyes, 
the negative effect was swallowed up in the inmiensity 
of those positive effects which had opened before me — ^in 
the abyss of divine enjoyment thus suddenly revealed. 
Here was a panacea for all human woes. Happiness 
might now be bought for a penny. Peace of conscience 
and ease of soul can now be corked in an ounce bottle 
and carried in the vest pocket." But listen, by and by, 
the pleasures have a grave and solemn complexion. In 
his happiest state the opium taker cannot "present 
himself in the character of L' Allegro— even then he 
thinks and speaks as becomes II Penseroso." Then after 
writing fully an hundred pages on "The Pleasures of 
Opium," he ends with these expressive words :"But now 
farewell, a long farewell to happiness, winter or sum- 
mer! Farewell to smiles and laughter, farewell to 
peace! Farewell to hope and tranquil dreams! Fare- 
well to the consolations of sleep! These were once my 
joy ; they have gone. I am now arrived at the Iliad of 
vroes ; for I now have to record the pains of opium. 

* * * * As when some great painter dips 

His pencil in the gloom of earthquakes and eclipses." 

Then follow the most heart-rending descriptions of 
sleepless stupidity, ghastly dreams and phantom shad- 
ows, 'till at the end he exclaims: "My sleep is tumul- 
tuous, and like the gates of Paradise to our first par- 
ents when looking back from afar, it is still (in the 
tremendous lines of Milton) "With dreadful faces 
thronged and fiery arms." 

In one of his beautiful translations from Ovid, Alex- 
ander Pope sweetly sings the tragedy of Sappho, an an- 
cient Greek poetess. So great was her unrequitted love 
for Phaon that she retired to the temple of Apollo on a 

17 



258 ^^^ ANNUAL ORATION. 

promontry of Leucadia, from which she cast herself in- 
to the tumultous sea below. Oh unsatisfied longing! 
How forcibly does this Greek legend illustrate the mad 
passion that binds its devotees to opium. Friendship, 
prosperity, home, loved ones, and life itself are gladly 
sacrified on the altar of this disappointing drug. 

"Oh, sly deceiver, brander o'er and o'er, 
Yet still believed, exulting o'er the wreck, 
Of sober vows." 

The last form of intemperance to which I shall direct 
your attention is certainly the most general and prob- 
ably the most serious yet considered. I venture the as- 
sertion that there are few families exempt. I refer to 
excessive eating. 

Memory of college days recalls one Saturday evening 
when the week's work was completed. A buoyant young 
friend with an appetite like that of voracious Samuel 
Johnson proposed that three of us should enjoy all the 
bananas we desired and he who ate the least number 
should pay for the entire lot. After eating nine I was 
glad to settle for thirty-three bananas. This I mention 
as an illustration of the foolish extent to which intem- 
perate diet is often carried. Referring to the prevalence 
of over-eating in his early day the "Philosopher of the 
Tub" once said : "As houses well stored with provisions 
are likely to be full of mice, so the bodies of those who 
eat much are full of disease." The thought embraces 
much medical knowledge, for there is probably no more 
prolific cause of physical distress and mental stupidity 
than excessive gratification of the appetite. Dilated 
stomach, chronic gastritis, hepatic torpor, gout, rheu- 
matism, uric acid diathesis, and chronic Bright's dis- 
ease are but a few of the ills resulting from this phase of 
intemperance. In his "History of the Roman Empire" 
Edward Gibbon relates that one Soliman, Mohammedan 
Caliph, ate at a single meal "70 pomegranates, an entire 
kid, 6 fowls and a huge quantity of grapes." From this 
we may suppose that over-eating is not strictly a latter 
day fashion. 

In his Anatomy of Melancholy Burton says: "Glut- 
tony is the source of all our infirmities, the foundation of 
all our diseases ; as a lamp is choked by a superabundance 
of oil, a fire extinguished by an excess of fuel, so the 



WILLIAM QROCB HARRISON. 269 

natural heat of the body is destroyed by intemperate 
diet." 

"Fat paunches have lean pates, dainty bits make rich 
the ribs, but bankrupt quite the wits/' writes Shakes- 
peare. 

So much for intemperance. Now, my brother physi- 
cians, let me briefly allude to our relations to this in- 
sidious, multiform, ever-present intemperance. 

Are we, as conservators of the public good, trusted 
guardians of the individual health, sufflciently careful 
to discourage every phase of excess and to obviate every 
source of danger? 

We may rightly esteem it outside our province to ad- 
vise against the intemperate talker, but should we not 
frown on every phase of intemperance which either di- 
rectly or indirectly aflfects individual health? Does 
tight lacing cramp the bodily organs and impair their 
functions? Then let us persistently condemn it. Does 
a heavy skirt tied about the waist distort the body and 
prove a drain on strength? Then let us condemn this 
fashion. Do long trains gather up the germs of disease 
and seeds of death to harbor them in the home? Then 
let us condemn the custom. 

Is it true that tea, coffee and tobacco are never of 
real value as foods? Is it true that one addicted to 
their use finds it difficult to dispense with them? Is it 
true that they impair the best digestion, and in excess 
are capable of serious evil? Then let us caution extreme 
moderation. 

In our prescriptions containing the various narcotics 
are we sufficiently careful to direct that they shall not 
be refilled? In our hurry to finish with a suffering 
patient and ansi;\^er the next call are we not too free in 
the use of hypodermics and less attentive to heat, cold, 
and nature's harmless remedies? Almost every response 
to the eighty letters I mailed to the various druggists of 
the State says most of the drug fiends begin the habit 
following some spell of illness. The accusation is freely 
and often made by the laity that careless dosing on the 
part of physicians is the most prolific cause of excess 
along this line. 

Out profession likewise suffers the indictment of 
manufacturing drunkards. To those who resort to a fre- 
quent use of alcohol let me make one special appeal. If 



260 STHi; AimuAL oration. 

Uis the alcoholic effect you wish to attain (and surely 
no one claims any other effect from the popular bever- 
ages) why prescribe wines, ales, and whiskies of such un- 
certan strength? You cannot tell within 50 per cent, 
of how much alcohol a certain sample of whisky will 
contain. With no other drug would we submit to such 
varying strength? To escape all errors and yet attain 
our aim, how much \^iser to use pure alcohol diluted 
with water. By this we avoid all uncertain strength, 
prescribe a remedy of known power, and, avoiding the 
more popular beverages, we thus remove our patient 
from a great source of temptation. This I believe to be 
the practical solution of the alcoholic problem, so far 
as medicine is concerned. The suggestion was long ago 
made by Dr. N. S. Davis, the Nestor of American Medi- 
cine, and will, I believe, soon increase in popular favor. 
In one of his "Dialogues of the Gods," Lucian represents 
Hercules and Aesculapius as quarreling with each other 
as to which shall occupy the higher seat in heaven. 

With most positive and emphatic decision, Jupiter 
grants the favor to the god of Medicine — intimating that 
it is more blessed to save life than to destroy it. 

Pope says : 

**A wise Physician, skilled our wounds to heal, 
Is more than armies to the public weal." 

When the final day of reckoning comes I firmly be- 
lieve the family physicians of our land will receive a 
high place. I never question that in unselfish devotion, 
sweet spirited charity, and genuine worth, the physician 
is the peer of any class. 

"Unskilled he to fawn or seek for power it. | , 

By doctrines fashioned to the varying hour, ; ; - 

For other aims his heart has learned to prize, 
More bent to raise the wretched than t» rise." 

But, brother doctors, are our skirts entirely clear 
along the line of guarding against intemperance? Are 
we exempt from censure? To discourage excess and im- 
moderation of every kind should be our constant aim 
and holy endeavor. No one enters the inner courts of 
personal secrecy with such freedom as does the doctor. 
It is here we can help to solve temperance problems. It 
is here we can guide aright the wayward, cheer the dis- 



WILLIAM ELI AS BROWLEE DAVIS, 261 

consolate, and ''lift up the fallen." With minds un- 
clouded by any form of dissipation ; hearts strengthened 
for any fray and a helpful hand may we battle forever 
for Truth, Temperance and Health. 

And, finally, my friends, let us daily cultivate a spirit 
of moderation in all things. 

In speech, 'tis a benediction; in fashion, a jewel; in 
drinking, a blessing; in eating, a necessity. 



MONITOR'S ADDRESS. 



By William EjLias Bbownlee Davis, M. D., Bibminoham. 
Senior CounseUor of the Medical Association of the State of Alabama. 



Mr. President J and Fellow Members of the Medical Asso- 
ciation of Alabama, Ladies and Gentlemen : 

I voice the sentinment of the visiting members of our 
Association in expressing the pleasure we experience 
in meeting again in the Central City of Alabama, full 
of historic interest, with its beautiful homes, lovely wo- 
men, and splendid men. The names of Pettus, Morgan, 
Rucker, Ward, Johnston, and Hardee are the pride of 
the entire State. As physicians, we recall with special 
pleasure the lamented Clarke, Park, Clark, Riggs, Mc- 
Kinnon, Tipton and Johnston. They form a galaxy of 
bright stars on the medical firmament of Alabama. 

When our distin&:uished President informed me of my 
appointment to deliver this address, I did not fully real- 
ize the responsibility I was to assume in attempting to 
prepare something suitable for this occasion. However, 
much of what I lack in ability is in a measure compen- 
sated for by my enthusiasm for the medical profession, 
and particularly that portion represented by the Medi- 
cal Association ot Alabama. 

There was a time, in my early professional career, 
when I possessed a burning desire to give advice to this 
Association. I was deeply impressed that I held opin- 
ions which would be of material value to the organiza- 
tion. It was some seventeen years ago when this respon- 
sibility — ^this professional burden — ^^re down so heavily 



2g2 ^^^ MONITOR'S ADDRESS. 

on my mind. Yet, notwithstanding the fact that the 
Association refused to change its course, did not show 
in a very marked way its appreciation of my proffered 
advice, it has continued to grow in strength, wielding a 
most beneficial influence on the profession and accom- 
plishing much for the public weal. 

At considerable expense I assisted in establishing a 
medical journal, through which I might reach the profes- 
sion and bring about these "greatly needed" reforms. I 
pleaded for higher medical education, a complete change 
of our system of examinations, better medical literature 
in the State, and so on. Well do I remember the pride 
I felt when I wrote in my salutatory that the Journal's 
object would be *^o promote a higher standard of medi- 
cal ethics and to improve the medical literature of the 
South and West, and especially that of Alabama." The 
salutatory went on to say that the objects of the Asso- 
ciation were laudable, but that there were many defects 
in the modes of accomplishing or carrying out the pur- 
poses of this organization. It informed its readers that 
these defects would be pointed out by the Journal, and 
each in turn would receive due consideration. 

I have often felt humiliated by these early signs of 
misdirected energy, but have been somewhat relieved of 
my embarrassment of late by seeing some excellent men, 
fifteen years after these experiences of mine, acting 
along the same lines, with an apparent feeling of 
the same grave responsibility. Indeed, many of their 
suggestions are good, just as mine were, but untimely 
and inexpedient. 

You marvel, I am sure, why I should have been se- 
lected to recite to you ethical trutha The subject of 
Ethics has been dealt with by the ablest minds of all 
ages, and I shall not attempt to discuss the teachings of 
Plato, Aristotle and the rest. All agree that it is the 
province of Ethics to define what is right, and Tve are 
taught that this is embraced in those golden words, 
"Whatsoever ye would that men should do to you, do ye 
even so to them." Mr. Huxley in his analysis of the 
golden rule, says : However much one may admire the 
generosity of such a rule of conduct, men may be de- 
pended upon not to carry it out to the full logical con- 
sequences; that these consequences are incompatible 
with the existence of a civil state, as the desire of the 



WILLIAM ELIAB BROWNLES DAVIS. 263 

wrong-doer is to escape from the consequences of his ac- 
tion. '^If I put myself in the place of the man who has 
robbed me, I am possessed by the desire not to be pun- 
ished." "Strictly observed," says he, "the golden rule in- 
volves the negation of law by the refusal to put it in mo- 
tion against law-breakers. It can be obeyed, even partial- 
ly, only under the protection of a society which repudi- 
ates it. Without such shelter, the followers of the golden 
rule may indulge in hopes of heaven, but they must reck- 
on with certainty that other people will be masters of the 
earth." He illustrates by asking, what would become of 
the garden if all the weeds and slugs and trespassers 
should be treated as if the gardener were in their place. 

Mr. Huxley fails to recognize the moral law which 
punishes crime and which calls for just discrimination 
in all our acts. The upright man must not assume that 
he is a criminal, for such a position would be inconsist- 
ent with his life, and impossible for him to appreciate. 
Mr. Huxley's reasoning, while at first sight appearing 
logical, leads to conclusions which are far from the 
truth. 

The very fact that there is a difference of opinion as 
to how the golden rule should be interpreted makes a 
code of ethics necessary and the code of the American 
Medical Association is the medical profession's interpre- 
tation of this rule, and it has proven of inestimable 
value to have these rules of conduct so ably formulated. 

I now come to the subject which I have selected for 
my remarks : 

THE MEDICAL PROFESSION AND THE PUBLIC. 

"Unfortunately for the profession and the public, phy- 
sicians have not become as prominent in public matters 
as they should. They are among the most intelligent 
citizens and the members of no other profession are so 
much beloved."* In the family's time of sorrow and se- 
verest trials the physician is the ever-present friend and 
adviser. Indeed, he is one of the family, they speak 
freely before him and from him the "skeleton in the clos- 
et" is not concealed. It has been truly said that every 
good woman has the privilege of loving three men ; her 

•Dr. Hyer'a Address, Vol. 1. Southern Surgical ft OTuacologlcal 
Tnusactioni, 



264 ^^^ MOmTOR'B ADDREBB. 

husband^ her physician and her preacher. Howeyer, 
the preacher does not enter the home life and get into 
the hearts of his people as does the physician. He sees 
them, as a rule, in health, and when he is called to them 
in sickness it only '^devolves upon him to propound the 
doctrines of his particular creed, his responsibility 
being limited." The lawyer's relation is of a momentary 
nature and "occupies a relatively low place in the love 
and confidence of his clients." Yet, he is uppermost in 
influence in public matters. 

The lamented Peterson in his Presidential address be- 
fore this Association, spoke truly of the medical profes- 
sion when he said : "The power of genius and learning may 
sometimes elevate the doctor to considerable renown, 
but there are very few avenues to distinction open to the 
medical profession. It is said that law is the stepping- 
stone to political preferment, and common observation 
proves it. The members of the legal profession may as- 
pire to any office in this country; medicine is the step- 
ping-stone to nothing but hard work, self-sacrifice and 
martyrdom. 

"The only prize which comes to the most laborious 
worker is a large practice, which is acquired as youth- 
ful strength is waning and soon exhausts his remaining 
vitality. He is under the weight of an immense responsi- 
bility, and his reward on earth is often ingratitude. He 
has no time for social enjoyment, no time for sleep. 
Night and day toil. No time for any thing but work ; 
work until this constant mental tension snaps the thread 
of life and the soul is landed into eternity. 

"It is not an easy profession, but requires long and 
hard study — the novitiate being much longer than many 
other professions. It is expensive to learn, and not lucra- 
tive except in rare instances. ♦ ♦ ♦ The doctor must 
grow familiar with mental and physical suffering, and 
must see humanity strijyped of pride and all fictitious or- 
nament and undergoing the last fearful change from the 
erect and God-like image — the living temple of enshrined 
divinity — ^to the inanimate dust. In looking over the 
field we are impressed that medicine is the most pro- 
found study that can engage the attention of the most 
cultivated intellect but like other professions whose offi- 
ces are called for by the disagreeable incidents of hu- 
manity, it is only tolerated as a necessity." 



WILLIAM ELIA8 BHOWNLEE DAYIB. 266 

Under the title "Slaves to Precedent" the editor of one 
of our leading medical journals recently paid the medical 
profession a highly deserved tribute. Truly^ the leaders 
of our profession are not slaves to precedent, but are con- 
stantly devising methods and measures and making new 
discoveries, and devoting themselves to disseminating 
this knowledge. He says : 

"Of all the so-called "learned" professions in the mat- 
ter of progressiveness, the medical profession is surely 
first. As we well know, lawyers and judges are ruled 
almost entirely by precedent. However much we may 
be told that law is the crystalization of equity and com- 
mon sense, yet the fact remains that our courts of jus- 
tice are ruled today by the rulings made in the past, 
and lawyers busy themselves not in endeavoring to ap- 
peal to the sense of fairness of the judge sitting upon 
the bench, but to influence and direct his decisions by a 
formidable array of previous judicial decisions, the auth- 
ors of many of which have long since been dead. 

"In the church it has ever been the custom to bow the 
head abjectly to the rulings of the past church rulers, 
rather than to move outside of the beaten path." 

As illustrating the disposition of human nature to 
move along the lines of least resistance, through the 
paths that others have trod, and to indulge in as little 
thinking for themselves as possible, he quotes as follows 
from Sam Walter Foss, with the title of "The Oalf-Path." 

One day, through the piimeyal wood, 
A calf walked home, as good calves should. 
But made a trail all bent askew, 
A crooked trail, as all calves do. 

Since then, two hundred years have fled. 
And I infer, the calf is dead. 
But stiU he left behind, his traU, 
And thereby hangs my moral tale. 

The trail was taken up next day 
By a lone dog that passed that way; 
And then, a wise bell-weather sheep 
Pursued the trail o'er vale and steep. 
And drew the flock behind him too. 
As good bell-weathers always do. 



266 ^^^ MONITOR'S ADDRESS. 

The years imaaed on in swlftneaa fleet. 
The road became a village street; 
And this, before men were aware, 
A city's crowded thoroughfare; 
And soon the central street 
Was this of a renowned metropolis. 
And men, two centuries and a half. 
Trod in the footsteps of that calf. 

Each day, a hundred thousand rout 
Followed the zigzag calf about. 
And o'er his crooked Journey went. 
The traffic of a continent 
A hundred thousand men were led 
By one calf near three centuries dead. 
They followed still his crooked way. 
And lost one hundred years a day. 
For such a reverence is lent 
To well established precedent. 

The physician must be a student of human nature. 

He often profits from his knowledge of Shakespeare 
more than from what he has learned in his medical books. 
He appreciates the effect of the mind over the body 
as well as that there must be a healthy body for a healthy 
mind. He understands that many church members who 
feel doubtful about their salvation and sure that they 
have fallen from grace are good christians and only need 
medicine for the liver. "His knowledge of the enthusiast 
and hyochondriac enables him to deal with both advan- 
tageously." Full well does he know the value of dis- 
creetness. "He is the repository of the secrets of the 
community and gives out nothing." The virtue of hope 
and cheerfulness is taught in his every-day life. 
* One should be careful in the seclection of a physician, 
and having done so should turn himself or herself over 
to him without reserve. The position of the patient to 
physician has been likened to and is well illustrated by 
the captain who places his ship in the hands of the pilot 
as he enters the harbor. The captain needs only to ex- 

*Dr. Hyer's Address, Vol I. Transactions Southern Surgical and 
Gynecological Association. 



WILLIAM ELIAS BROWNLEE DAVIB. 267 

plain some of the peculiarites of the ship — the pilot is 
in control. Of course the patient should explain to the 
physician any idiosyncrasies. No class of men do so 
much for the poor as the medical profession, and if able 
the patient should promptly discharge his financial obli- 
gation to the physician. A man who can and will not 
pay his physician deserves the severest condemnation. 
In this connection you will pardon my reading some 
lines on "Good Enough For Me," by Dr. G. A. Moore, 
which always appeal to the doctors : 

For a doctor, old and weary, 

From his life of toil and love. 
Came an angel down from heaven 

To transport his soul above. 

Said the angel: "I'm from heaven; 

The Lord Just sent me down 
To bring you up to your reward; 

To wear your golden crown. 

"You have been a friend to ev*ry one. 

And workt hard, night and day. 
You have doctored many thousands, • 

And from few received your pay. 

"So we want you up in glory, 
You have toiled both long and hard; 

And the good Lord is preparing 
Your eternal, just reward." 



Then the angel and the doctor 
Started up toward Glory's gate, 

But when passing close to hades. 
The guiding angel murmured, "Wait! 

"I have here a place to show you. 
It's the hottest place in hell. 

Where the ones who never paid you 
In eternal torment dwell." 

And, behold, the doctor saw there 
His old patients by the score; 

And, taking up a chair and fan 
He wisht for nothing more. 

But w;a8 bound to sit and watch <them 
As they sizzle, singe and bum. 

So his eyes would rest on debtors 
Whichsoever way they'd turn. 

Said the angel: "Come on, doctor. 
There's the pearly gates I see;" 

But the doctor only muttered: 
"This Is good enough for me." 



If 



268 ^^^ MOmTOR*B ADDREB8. 

80 far I have said nothing of the obligations of the 
State to the medical profession. Alabama has the most 
complete organization of the profession in the Union. 
It was the first to establish a satisfactory system of 
health laws. There are about twelve hundred members 
of the various County Societies, and these are de facto 
members of the State Association, and vote through 
their respective delegates, two being allowed from each 
county. One hundred counsellors, elected for life, are, 
in addition to the delegates, entitled to vote. The or- 
ganization thus constituted has every element of 
strength and permanency. With all this to commend it 
to the public, it has been intrusted with the execution of 
the laws of health of the State, and empowered to pass 
upon the qualifications of candidates to practice medi- 
cine in its territory. Its legal power exceeds that of any 
other State organization. All this was brought about 
by the medical profession, under the leadership of the 
lamented Jerome Cochran, to whom this magnificent or- 
ganization is a monument more enduring than marble. 
I have not language to express to you the magnitude of 
this great man's work for Alabama. None of her other 
sons have accomplished so much. In our sorrow at his 
loss, let us be sufficiently thankful that his mantle has 
fallen upon one so worthy as our present Senior Censor. 
Too much praise cannot be given for the able and inde- 
fatigable manner in which Dr. Sanders has conducted 
the affairs of his responsible office. 

The work of the State Board of Health, especially 
for the past five years, has been onerous, and oftentimes 
critical and delicate in nature. The appropriation made 
by the State for this work has been exceedingly small. 
Many of the counties have paid their health officers for 
collecting vital statistics and supervising county sanita- 
tion wholly inadequate salaries, and some of them no 
salaries at all. The various committees of public health 
— State and county — do their work gratuitously . No 
less than f 150,000 worth of labor of the kinds men- 
tioned, is being performed annually for the public by 
the medical profession, for which the State appropriates 
about |4,000 and the counties, all told, about f 8,000. 

You readily see that something is radically wrong 
when so little is done by the public. This must be due 
to the want of appreciation on the part of the laity of 



WILLIAM ELIA8 BROWVLEE DAVIS. 269 

what may be accomplished by the profession. The value 
of these services can in a measure be understood when 
it is remembered that typhoid fever epidemics may be 
controlled, small pox and other contagious diseases cir- 
cumscribed or eliminated, and yellow fever kept out of 
the State through the Boards of Health, with the sav- 
ing of thousands of lives and hundreds of thousands of 
dollars annually. Unfortunately, the legislators are in- 
clined to regard the medical organization as a trust, 
looking out for its own interests. They do not seem to 
understand that the members of the profession, by limit- 
ing the spread of disease, by enforcing sanitary meas- 
ures, reduce their incomes. It is with much ef- 
fort that the profession is enabled to keep our 
laws intact, and almost impossible to secure additional 
sanitary legislation. Even vaccination, the value of 
which has been demonstrated beyond all question, has 
its opponents in the Legislature, and the State of Ala- 
bama has lost perhaps one-half million dollars on ac- 
count of its failure to pass a compulsory vaccination 
law. A prominent member of the Legislature is reported 
to have said that this was a free country, and the man 
who persisted in his efforts to vaccinate him or his fam- 
ily would be met with a shotgun. A leading business 
man in one of our Alabama towns, three years ago, op- 
posed every eiJort of his townsmen to enforce vaccina- 
tion, and made himself very conspicuous and obnoxious 
thereby. Only a few weeks elapsed when he was seized 
with a malignant form of the disease and died. His 
widow was a patient of mine soon afterwards, and, natur- 
ally, was plunged in deep grief. Whilst sympathizing 
with her, you will forgive me, I trust, if I express a 
half conviction that her husband deserved his fate for 
having defied the teaching of science by refusing to avail 
himself of the protective power of vaccination. 

I hear you say : "The profession has quarantined yel- 
low fever instead of the mosquito, which recently has 
been shown to spread the disease." I answer : The mos- 
quito must get the blood from the yellow fever case, and, 
besides, the demonstration that the mosquito pays so im- 
portant a part in the distribution of the disease was the 
work of the medical profession. I may also remind you 
that Alabama has escaped the disease through the vigi- 
lance of her able Health Ofllcer. Says Dr. St. John 



270 ^^^ MONITOR'S ADDRBBB. 

Boosa, (Medical Record) : "The record of the last cen- 
tury, as detailed in one of our newspapers, by Osier and 
Keen, is sufficient justifi'cation for my claim that the 
public and the State owe so much to medical science that 
they ought to cherish and maintain the medical profes- 
sion at the highest perfection. • • ♦ In the Nine- 
teenth century the catalogue of achievement is long. The 
advances that have been made in medical science have 
not been the work of great syndicates with tremendous 
financial backing, and all the paraphernalia and money 
of great corjmrations in the full glare of the world, but 
oftentimes of private individuals, unaided by public 
funds, public institutions, or private gifts — ^alone in the 
laboratory or the consulting room, or in the wards of the 
hospital, or over the patient in the cottage, or the ham- 
let or the tenement house of the crowded city. These 
great deeds have been self-inspired by the physicians and 
surgeons who have wrought them out. Mighty problems 
they have been. 

I will not occupy your time in relating the many ad- 
vances and discoveries of the past century. Think of the 
germ-theory of disease, general and local anaesthesia, 
antiseptic surgery, the Roentgen ray, the ophthalmo- 
scope, the stethoscope, the laryngoscope, the cystoscope, 
Sims' speculum, and much more. 

I cannot pass this part of my subject, however, with- 
out reminding you that the surgery for the relief of dis- 
eases peculiar to women had its origin in this State. To 
Marion Sims is due this credit. It has been well said : 
"The outcome of the labors of this great man has no 
parallel in the annals of medicine." He has conferred 
upon Alabama the honor of being the birth-place of 
gynecology, and "has done more to alleviate the suffer- 
ing, restore the health and prolong the lives of women 
than any other man, living or dead." The lamented 
Haggard of Nashville said of him : "To those who knew 
Sims personally he gave inspiration while he lived, and 
now that he is dead he has become a tradition; and his 
teaching, his example, and his labors have passed into 
history and coupled his name with the practice of an art 
which will illuminate the ages to come." 

The law empowering the profession to pass upon the 
candidates to practice medicine in the State is a very 
important one, and is contested at almost every meet- 



WILLIAM ELIAB BROWNLEE DAVIS. 271 

ing of the Legislature. It is argued that the Examining 
Boards reject applicants for selfish motives. It 
will be of interest to you to know that State examina- 
tions are not opposed by the schools of medicine, which 
require a knowledge of the fundamental principles of 
m^icine. The Homeopathic and Eclectic physicians, 
as a rule, advocate such an examination. The opposition 
comes from the Christian Scientists, Osteopathist, and 
the like, who possess almost no medical knowledge. The 
course of study in the Homeopathic school — and I use 
this school as a type of the irregular schools requiring 
professional qualifications — ^is quite thorough, and the 
regular medical profession makes no legal objection to 
its mode of practice, but cannot endorse its dogma — 
"Similia similibua curantur/^ which is only true very ex- 
ceptionally. It was the founder of this school who dub- 
bed the regular medical profession "Allopathy," con- 
veying the impression that its practice was the reverse 
of Homeopathy. The regular profession has repudiated 
this, of course, as it has every other dogma. It has re- 
served the privilege of practicing w^hat has proven to be 
of value from whatever source, and I may say some 
things which are of no value, whether from Homeopathy, 
Christian Science, or elsewhere. The regular profession, 
by evolution, through discoveries in medicine and sur- 
gery, has, within a comparatively short time, materially 
changed its conception of diseases and their treatment. 
The Homeopathic school has had a similar experience. If 
both schools had been kept in ignorance, as the Chris- 
tian Scientist, OsteopatMst and Magic Healers have, 
they would have continued widely separated, but the 
fact is there is now little diflPerence except in name. 
Homeopathy would no longer be applied to this school 
of physicians but from the fact that so many wealthy 
families selected as their physicians the fol lowers of this 
dogma in its early history, and have made large dona- 
tions to its schools. Their descendants still demand the 
homeopathic physician, and the doctor himself having 
evolved so gradually from the original teachings of 
Hahnemann, scarcely realizes himself that he is no 
longer practicing what the people expect, and what 
Hahnemann taught. 

Specialism, which is almost equivalent to exact 
knowledge, leaves no room for any other school than 



272 ^^^ MomToiVB addrmbb. 



-1 



that of regular medicina The specialists are largely 
from the regular profession, and those from the Homeo- 
pathic school do not claim to be in any way different 
from those of the regular profession. Therefore, as the 
specialists of both schools are one, and as the specialists 
cover every part of the organism, there is comparatively 
little left for the general practitioner to speak end write 
about authoritatively. The standard text books on the 
Diseases of Women, the Eye, Nose, Throat, Chest, Ab- 
domen, etc., etc., are the standard books for all schools. 
Hence, knowledge in the form of specialism has brought 
tflie schools of learning very close together. 

The fight being made annually by the Osteopaths, 
Christian Scientists and "other classes of imperfectly 
educated people" does not disturb the national govern- 
ment, but is an ever present source of danger in our 
State law-making bodies. I quote from Dr. Boosa as 
follows : **The national government allows no illusion in 
regard to the value of medical education for its soldiers 
and sailors. Christian Scientists, Osteopathists and im- 
perfectly educated people of no pathy, but with a gift 
of healing, have no opportunity for exploiting them- 
selves as medical officers of these two departments of the 
government. Like the State of New York, the United 
States is not content with a diploma of doctor of medi- 
cine and surgery for its medical officers, but the govern- 
ment insists on a separate, independent, examination for 
general and technical qualifications before it allows a 
man to practice medicine among the soldiers of the 
United States army or the sailors and marines of the 
United States navy." In support of the necessity of 
medical laws in order to protect the people from in- 
competent practitioners of medicine and all of those 
who make a business of treating diseases, the Pennsyl- 
vania courts have expressed an opinion which I quote 
from as follows : "The experience of the past has justi- 
fied the wisdom and necessity of medical laws. There is 
no time perhaps in the experience of life that persons 
are more susceptible to imposition than when sick or in 
failing health. They are ever as ready to catch stra\^^ as 
a drowning man. The profession that involves the price 
or value of human life demands of its practitioners a 
higher degree of edu"cation in all its branches, and such 
degree of honor and character enables them fully to ap- 



WILLIAM BLIAB BROWNLEE DAVIB. 273 

preciate the important and confidential relations ihey 
sustain to their patients." 

Mr Jacob Bowlin, of New York, in a statement made 
on Osteopi^thj before the CJommittee of Health of the 
New York Assembly, (Medical Record), said: 

"I have been elected to represent the laity in onr so- 
ciety, and to give you our views on this matter. 

^The questions for me to answer are simply these: 
What relations exist between Osteopathy on the one 
hand and massage and medico-gymnastics on the other? 
What are their similarities and differences? And how 
does this bill, if it becomes law, affect those who practice 
massage and medico-gymnastics? 

^^Let me then state that here, as in so many other 
cases, that old BSLying slightly changed is true : What is 
good in osteopathy is not new ; what is new is not good. 
Manipulations and movements have been used in the- 
rapy from time immemorial. It is not necessary to re- 
fer to the ancients, but you should know that from 1804 
they were set into system in Sweden by P. H. Ling, and 
were in 1813 recognized by the government as a legiti- 
mate branch of therapy, and at the present time they 
are so recognized. But even in that country where these 
practices are unqualifiedly better understood than any- 
where else, where the course of instruction has a dura- 
tion of three years, and the students must have a pre- 
liminary knowledge corresponding approximately to the 
academic degree of B. A. before they may even enter 
upon their duties, the government does not allow the in- 
dependent practice of the graduates of its own institu- 
tion, but requires a certain amount of cooperation be- 
tween them and the legalized physicians. In this bill it 
is proposed to give independent practice to persons who 
may have taken a course of a month or a corresponding 
course of a few months. When the standard of medicsd 
education in the State has been laboriously raised to ap- 
proach that of Europe, is it not an arrogance, an au- 
dacity, a crime, aye, even a stupidity, which is perhaxM 
still worse, to try to degrade it with one stroke? 

^^he treatment of disease by manipulations and 
movements is not, then, a new discovery, as claimed. 
Nor is it new in this country. From Sweden it was in- 
troduced into New York by two physicians, the two 

18 



274 ^^^ MONITOR'S ADDRB88. 

brothers Taylor, in the fifties, and it is now practiced 
more or less successfully by several hundred persons all 
over the country who have gained no new knowedge 
from the Osteopaths. ♦ ♦ ♦ 

"They see dislocations and subluxations everywhere. 
Last summer there came under my care a case of loco- 
motor ataxia where they had diagnosed a dislocation of 
the spine. Lees than two months ago I received from 
one of the most prominent neurologists in the city of 
New York, a patient with localized cerebral venous sta- 
sis. They had discovered a subluxation in his neck! 
That is one difference between them and us. We take 
the diagnosis of the physician. They claim to make 
their own diagnosis, and it is practically always the 
same. Why, if any one of you should put yourself in 
their care you would undoubtedly be found to have a dis- 
location of the neck. And still I will warrant that it 
is not your head which has been turned, but theirs — 
turned completely around and topsy-turvey into the bar- 
gain." 

In our own State strong arguments from the stand- 
point of the laity have been presented in favor of Osteo- 
pathy. I am told that a prominent woman was allowed 
to go before the Senate, and with tears in her eyes and 
with appealing argument, had many of those gentlemen 
very much in sympathy with her, and when she came 
down from the stand they crowded around her and ex- 
pressed admiration for her courage and sympathy 
in her cause. It is also stated that practitioners of 
Osteopathy appeared before the Legislative Committee 
and that they used many arguments calculated to in- 
fluence those not well schooled in these matters. The 
woman said that it was cruel to deprive suffering hu- 
manity of the help which these healers could give, and 
then a practitioner of Osteopathy with great gravity 
addressed the committee. Among other things he is re- 
ported to have said : "Gentlemen and friends, I want to 
recite a case which recently came under my observation. 
A prominent gentleman consulted me who had been suf- 
fering with running from the ear, which was followed 
by great tenderness and redness and some enlargement 
behind that organ, just here (placing his finger behind 
the ear) . He had consulted eminent physicians and sur- 
geons and they had told him that an operation would 



WILLIAM ELIAB BROWNLBB DAYIB. 276 

be necessary. He objected tx) subjectmg himself to the 
great risk of such a procedure, and as a last resort came 
to me for relief. Now, gentlemen, I simply took his head 
in my hands and by a very simple manipulation replaced 
his atlas, and he was completely cured." 

Ladies and gentlemen, this was a •case of mastoid in- 
flammation following middle-ear disease, and the opera- 
tion for its relief is attended with almost no danger. If 
the man recovered without an operation, which is 
scarcely probable, it was due to the evacuation of the 
pus by the efforts of nature. The Osteopathist says he 
replaced the atlas, and that means the man's neck was 
dislocated. What a shame in this day of enlightenment 
that such a fraud should be permitted! Yet the ma- 
jority of the Senate Committee, who, of course, did not 
know the atlas from the os calsis, were, I am told, 
greatly impressed with this appeal and were disposed to 
report favorably on the bill in their behalf. A distin- 
guished member of the medical profession fortunately 
was able to show them the fallacy of these claims and the 
justness of our law, requiring examinations on the fun- 
damental branches of medicine. He appealed to the 
committee in a very practical and forcible way. He said 
he understood the followers of this practice proposed to 
cure everything by rubbing, and addressing his remarks 
to a gentleman who possessed a threshing machine, he 
asked him if he would be willing to trust a man to re- 
pair his machine, when broken, entirely by rub- 
bing. Would he think it unreasonable to require 
the man to know the different parts of the machine 
and their functions? "That," said he, "is what Ala- 
bama requires. The applicant to practice must pass an 
examination upon anatomy, physiology and the other 
fundamental branches." He used the same argument 
with the owners of a gin or of a cane mill. They all 
agreed that one proposing to remedy the defect in these 
machines should know the different parts and their func- 
tions, and admitted that rubbing would be good in some 
conditions, but that its field would be quite limited. So, 
our representative of the medical profession had the com- 
mittee in good preparation for a very forcible illustra- 
tion, which he then made. Said he : "Tou have been hear- 
ing a good deal about pathies, viz. Osteopathy, Hydro- 
pathy, Homeopathy, and Allopathy. Now, I have an- 
other pathy, and one which has a great many followers. 



276 ^^' MomroiPB addrebs. 

This flchool is known as cow-pathy^ and can show many 
cures. Here is a beautiful woman who, owing to family 
cares, worry, mental strain, and so on, has lost her 
strength and flesh. Her apiJetite is poor and she feels 
uncomfortable after eating. She suffers from insomnia ; 
little troubles annoy her greatly, and she is depressed 
and always anticipating some calamity. The cow-path- 
ist says to this patient: "Follow my instructions and 
you will be cured. On the first day of treatment before 
breakfast you must walk one hundred yards in this cow- 
path and return ; two hundred yards and return on the 
second day in the same cow-path ; three hundred yards 
and return on the third day, and so on until you have 
walked three miles or more." Who will claim that this 
woman's appetite will not be restored and her health 
much improved before she had walked the three or six 
miles before breakfast." "But," said he, to the com- 
mittee, "you would not claim that it was cow-pathy that 
cured the woman, but well-directed exercise. This," 
said he, "is an illustration of the fallacy of the claim of 
the osteopathists." 

Osteopathy is only massage, and is good only when 
applied to properly selected cases, which the well-pre- 
pared physician only can determine. Electropathy and 
Hydropathy are also of value in the same way. One of 
the most valuable methods of treating a class of nervous 
break-downs is known by the profession as the rest-treat- 
ment. Yet we do not think of establishing a separate 
school of medicine to practice the rest-cure. 

The false conceptions of the treatment of diseases by 
many otherwise highly intelligent i)eople, is a serious 
menace to the health and lives of a large portion of our 
population. Education is needed, but it is difficult for 
the laity to become sufficiently informed on these mat- 
ters as to draw logical conclusions thereon. The public 
is to be sympathized with more than blamed. It re- 
quires years of study and experience in the profession for 
these principles to become a part of one's life, not to 
be shaken by present-day frauds. The ignorance of the 
press and the clergy on these subjects is greatly to be 
deplored. Every newspaper of consequence should have 
a well-informed physician connected with its staff, to 
advise it on medical matters, the most important ques* 



WILLIAM ELIA8 BROWNLEE DATIB. JJ77 

tions that could possibly concern the public. The ad- 
vertisements for patent medicines and quacks which ap- 
pear in our leading papers are a disgrace to our civiliza- 
tion. Books are suppressed, which are clean in compari- 
son with many of the advertisements for these quacks 
and nostrums. In addition to the moral and vulgar 
sides there is another evil to be considered. Drug 
habits are being formed daily by the use of these medi- 
cines nearly all of which contain narcotics and nervines. 
Patent medicine victims are all around us. The habit, 
once established, never ends, and these medicines make 
many patients for the physician. The clergy have done 
much harm in lending their influence and endorsement 
to these nostrums. They are furnished free bottles and 
the narcotics and nervines rejuvenate them temporarily, 
hence they feel better and are called upon to give their 
endorsement. Dr. Robert Battey has said that the clergy 
by virtue of their calling, teaching, as they do, faith in 
the unseen, are more easily deceived. This is readily 
understood. The fact that the leading men in this noble 
profession are now seldom found endorsing these evils is 
worthy of note. 

The outlook, I am gls^d to be able to state, is more 
promising than it has ever been. Our great magazines 
are distributing scientific knowledge broadcast. Train- 
ing schools for nurses are also great factors in the edu- 
cation of the laity. The people are growing better in- 
formed. The newspaper, clergy and physicians must 
assist in widening, deepening and distributing this in- 
formation. 

In the language of our motto, Ny>8 etiam meliora 
spercmmus — ^We even will hoi)e for better things. 



278 BiaTORiAirs addrsbb. 



HISTORIAN'S ADDRESS. 



Bt Jesse Obat Palmeb, M. D., Opelika« 
Member of the Medical Association of Alabama. 



Mr. President, and Oentlemen of the Medical Assoda- 
tion of the State of Alabama: 

History is the written record of the past. 

It is also such study of the present as tends to bring to 
us a knowledge of the unwritten past. The great pyra- 
mid is not history^ and until its inscriptions were de- 
ciphered was but an artificial mountain. 

The mounds over Ninevah were but heaps of desert 
sand whose excavation would have added but little of 
value to the history of mankind had not the inquiring 
genius of science spurred her votaries to diligent search 
until at last they found a key to the arrangement and 
meaning of the cuneiform characters ; and lo ! the story 
of Assyria was retold for modern readers. Fact by fact 
builds history as stone by stone, pyramids. Scholars 
have sought, and still are seeking, a philosophy of his- 
tory, a sort of language-key, that will enable them to 
prophecy future events by those that have gone before - 
From the days of Pythagoras men have striven to show 
that man and his environment react upon each other, 
and to deduce from the results some given law which 
will guide them toward the realm of prediction. But, 
even if partial success should crown such an effort, it 
still remains our duty to transmit to those who shall 
follow us correct records of the present. Though his- 
tory is not the chief function of language, it is not its 
least important one, and to those yet unborn the records 
of our lives, surroundings, and actions may be to them 
by far our most valuable bequest. Whoever, through a 
love of truth and devotion to duty, shall devote his life 
to the accumulation and preservation of beneficent 
knowledge, or of any series of truths, however trite and 
valueless they may now appear, will rear to himself a 
monument which future generations will appreciate 
and admire. 



JMI8SE GRAY PALMER. 279 

The earliest poets were historians. History was the 
very key-note of their songs. The more heroic the epic, 
the more of history did it sing. And so, today, our deeds, 
our lives, are making history. 

However commonplace and unimportant to us may 
seem the happenings of the hour, in some tomorrow of 
the centuries the record of them will be scanned and 
studied as the initiatory movements of events of vital 
import, now undreamed of. Every deed of valor, every 
tender sacrifice, every laborious effort after scientific 
truth, all these are the acts of men, living today, historic 
tomorrow, posing their little hour upon the stage where- 
in the wonderful tragi-comedy of human life is acted. 

The deed is seen, recorded, and becomes history. But 
who shall write the history of thought, with a world of 
delight all its own, and an influence over the doings of 
men that is immeasurable? Prehistoric man has left 
no story of his deeds, but of his thoughts, his hopes, 
fears, desires, we have an intelligible record in the 
names he gave to the constellations. 

Thought has given birth to all that distinguishes man 
from the rest of animal creation, brought safety out of 
danger, hope out of fear, light out of darkness, order out 
of chaos. By its power Napier consolidated figures into 
logarithms, Linnaeus named all living things, Franklin 
harnessed the lightning, and Newton weighed the sun. 
It gave to Darwin a working hypothesis for creation, 
and to Faraday the laws of matter and motion. Still 
leading onward and upward, it inspired the Teutonic 
peoples with a concept of freedom for all mankind, and 
upon this sublime idea, as an impregnable foundation, it 
has erected, stone by stone, the altars of liberty and the 
temple of representative government. In freeing man, 
thought freed itself. Freedom of thought is emancipa- 
tion from error. Since its shackles were broken it has 
made many gigantic strides ; but nowhere more than in 
our own profession have the beneficent results of this 
liberation from precedent been felt. Time was when 
to settle every controversy the inquiry was made : "What 
do individual authorities say?" Today the question is: 
"What does science say?" 

History shows that the sources of human activity are 
the various needs, ambitions, passions, characters and 
talents of men. Thus, though the blare of trumpets and 



280 HisfORiAira addbebb. 

waving of banners make the larger show in the world, 
history is not complete without the records of the lives 
of others than kings and warrior& In every civilized 
land today the members of our profession occupy an 
important and honorable x>osition. The followers of 
Hippocrates and Oalen are recognized elements of power 
and usefulness. If this be true of individual physicians, 
much more is it true of organized medicine. 

That grand old Nestor of this Association, Jerome 
Cochran, builded more wisely than was then dreamed of 
by his coadjutors when he founded the Medical Associa- 
tion of the State of Alabama. Year after year, he lab- 
ored over the conception of its plan, perfecting every 
detail, forseeing every danger and providing remedies 
therefor. It was a long and arduous struggle in the face 
of incredulity and opposition. At last, he and the faith- 
ful little band of friends who worked with him and 
under his direction succeeded. The Association was 
incorporated, the charter was secured. Thus did Jerome 
Cochran make history, and truly did he write in bold 
and beautiful characters upon a golden page. 

The task of continuing the work is now ours. Let us 
see to it that the transactions of this Association record 
the highest thoughts, the best professional work, of 
which we are capable. To this organization and it alone 
can we look for protection of ourselves and our fellow 
citizens from the horde of incompetents and pretenders 
who every year invade the State. No sooner is one tribe 
of quacks suppressed than another takes its place. The 
public is incompetent to judge of the capacity of any one 
to practice the complicated and important art of medi- 
cine, and sometimes, even in our legislative halls, our 
efforts to guard an indiscriminating people against the 
imposition of unscrupulous men are looked upon with 
suspicion. It is a strange circumstance that gentlemen 
who represent some parts of the State in the Legislature 
are unable to understand or believe that an organized 
body like this Association can devote its energies to any 
public measure, and yet be actuated by absolutely 
unselfish motives. The history of this Association has 
been one of unselfish efiFort for the public good. It has 
asked nothing for the benefit of itself, and for only 
enough money to execute the functions devolved upon it 
as a State Board of Health. More than any other South- 



JB8BB GRAY PALMER. 281 

em Board ot Health, it has succeenf ully protected the 
commonwealth against epidemic invasion. I am satisfied 
that all the opposition to our measures manifested by 
some members of the General Assembly arises from lack 
of information on their part, and that if they could once 
understand the purely altruistic standx>oint that we oc- 
cupy, they would at once become our advocates, instead 
of our opponents. 

It stands to reason that they desire the welfare of the 
State, therefore, if they would study these matters judi- 
cially, and without prejudice, they would become our 
warm friends and active supporters. The remedy is in 
our own hands, not as an Association, but as individuals. 
We are represented in every county. Let us make his- 
tory by seeing that our candidates for the Legislature 
will do us the justice of studying the situation, not from 
an ex parte standpoint, but fairly and impartially. If 
they will do this, we may safely rest the matter in their 
hands. 

During the past year not one member of the Col- 
lege of Counsellors has been called away by the grim 
messenger. That this circumstance is a fortunate and 
joyful one for your Historian to record goes without 
saying. The reports of the Vice-Presidents show a gen- 
eral improvement in all directions. Peace and harmony 
prevail throughout our organization. Though some of 
our members, moved by their great aflfection for the 
Association, think it threatened with decay, the bulk of 
the membership is sanguine and loyal, and the present 
meeting promises to be one of the largest and most suc- 
cessful in our history. We are growing yearly in x)ower 
and usefulness. So long as we continue unflinchingly 
to perform our duties, one by one as they arise, we need 
fear no attack. 

"Fearleas he seee, who is with honor crowned, 
The .tempest rage, and hears the thunder sound; 
Ever the same, let fortune smile or frown; 
Serenely, as he lived, resigns his breath. 
Meets destiny half way, nor shrinks at death." 

So lives and dies the conscientious doctor. No marble 
shaft may mark his resting place, but he is enshrined 
more royally than king or potentate in the grateful 
memory of those whose welfare was his first, his con- 



282 OUTLOOK OF MEDICIKE tB TOWARD PRBVEKTIOK. 

stant care. A grateful mother's *H3od bless you, Doc- 
tor!" is a benediction more sacred and profound than 
was ever spoken by priest or pastor. 

These are the historical events in the doctor's life. 
Everywhere as he goes from home to home it is also 
from heart to heart, and the seeds of brotherly love and 
human kindness he scatters with liberal hand. 

"The seed that In these few and fleeting hours 

Thy hands unsparing and unwearied sow, 

Shall deck thy grave with amaranthine flowers. 

And yield thee fruits divine in Heaven's Immortal bowers." 



THE OUTLOOK OF MEDICINE IS TOWARD 

PREVENTION. 



Bt Richabd Ckx)PENDEB Bankston, M. D., Bibminoham. 
Member of the Medical Association of Alabama. 



My subject is an old story. Years of effort, even de- 
cades of ^ucation, may be required to elevate the mind 
to comprehend its importance. With our present stand- 
ard of education it would be futile to hope for change 
of radical nature in our generation, but by urging the 
necessity of higher education upon our followers we 
may better equip them to solve the problem. As scien- 
tists, we should call attention to the subject and propose 
measures preventing the introduction of epidemic dis- 
eases, and seek the causes of endemic diseases and stamp 
them out by wise legislation which should acknowledge 
no right superior to public welfare, no law above self- 
preservation. Take the scourge, consumption, the death 
rate of which is greater than from all diseases of en- 
demic character combined. We know it to be infectious 
under exposure to its germs; with the functions of life 
lowered, so as to lessen vitality and impair resistance, 
its onslaught then is rapid and its ravages dreadful. 
€^ it be cured? We know more of it now than ever be- 



RlpHABD OOOPBNDBR BANKSTON. 283 

fore, yet we do not invariably cure it, which makes us 
believe our safeguard is prevention. Should it at any 
time be curable it would be during the stage of early in- 
vasion and not after its attack has developed in the tis- 
sues and changed their character thoroughly. It behooves 
the physician to agitate this subject, and I am sure an 
intelligent, humane people will endorse any measure ad- 
vanced that appears to have the requisites to get best 
results on this line of study. There has been no proposi- 
tion advanced for medical consideration that has a more 
important bearing upon the future of mankind than does 
the study of consumption, and means that will accom- 
plish its eradication. A comparison of past and present 
statistics, and prognosis drawn therefrom, warrants 
the strongest appeal which can be made to a^'aken inter- 
est in the study of this serious menace to posterity. The 
physiology of health is to keep the biological forces upon 
such a high plane of metabolic activity that all functions 
may be harmonized, and the powers of resist- 
ance so strengthened as to resist the onslaught 
of disease or the approach of degeneracy. When 
laws have been modified so as to weed out taints, 
prevention will be as real in result as the pres- 
ent course is chimerical in affect. The neces- 
sity of wise legislation for obtaining results will be 
recognized soon; that great investigator. Education, is 
certain to call attention to the need of restraint upon 
causes producing disease. As a prime consideration in 
prevention every one should study individuality. Take 
an inventory of physical and vital forces and resistance, 
conserve and use them wisely. Make sleep and physio- 
logical rest paramount. You will find force enough in 
stock to keep functions moving on a highly vital plane 
for a century or more. I do not mean for a man to en- 
dure a long old dotage. He will be robust and vital 
until near the end, which he can realize is coming by 
the cessation of force and vigor. I believe it was Sancho 
Panza who said : "God bless the man who first invented 
sleep." Man's future rests largely in sleep ! It is then 
that repair, growth and development are effected. Con- 
sequently, full hours of sleep mean perfection and de- 
velopment of strength necessary for conservation of 



284 OUTLOOK OF MEDICINB IS TOWARD PBEVBNTION. 

waning powers. The old flaw of the ^^Early bird catch- 
es the worm" can mean the demolition of the worm be- 
cause it arose too early, therefore, do not fear to give 
yourself enough sleep or it may be with you as it was 
with the early worm! These theories are worthy our 
thoughts. Some of them seem fully to fill prevention's 
perspective. The details of any special meth- 
od, whether it be vaccination, quarantine, or any 
measure applied for preventing infection from obtain- 
ing a foothold in a country, or of suppressing one, does 
not come within the province of this paper. The inten- 
tion here is to advocate the extermination of germs and 
all potentials of degeneracy, as the true means of pre- 
venting disease. By education the mind inclined toward 
the science of medicine can have the knowledge unfolded 
that is needed in development of the high intellectuality 
required in pursuit of possible prevention. Education 
will create a sentiment in favor of purifying the social 
and physical fabric, and preserving health that will un- 
fold to man a knowledge of self, delineate character, and 
teach our women that perfect physical welfare is the 
quality with which they ought to be endowed that they 
may be fitted to become mothers of a people of high type> 
superior faculties, and large powers of physical endur- 
ance. It will teach parents how to rear children to be- 
come integers in the problem of continuing the highest 
type of humanity, that morality may ripen into the best 
civilisation. It will show that science may develop and 
cultivate thetype best fitted to survive, and to perpetuate 
our kind. Educate, that the masses may learn better 
ways of living, of thinking, of economizing physical, 
mental and moral energies to the end that mind may 
know that disease is not an unavoidable concomitant of 
environment, but that health should be the normal condi- 
tion of modern civilization. It is useless to urge any 
measure of prevention upon people who do not under- 
stand the value of a high physical mental and moral 
plane of health. Such people must be educated and put 
in appreciative touch with facts relating to causation and 
perpetuation of disease by germs and virile poisons which 
can be traced to demonstrable, avoidable causes. Educa- 
tion with its concomitants, health and civilization, favors 



RICHARD COOPIBNDJBR BANK8T0N. 285 

the enjoyment of existence and prolongation of life. To 
elevate the status of education is not an abstract dream 
or Platonic aspiration, but is an interwoven reality with 
the life of posterity, and must prevail by its results. 
Man's improvement is indefinite. I do not believe so much 
in perfection as in progressive advancement through edu- 
cation. Remember one fact of importance — whatever 
deteriorates life or lowers vitality should be corrected, 
that the sum of individual existence may be lengthened. 
By transmission, that quality will influence progres- 
sively the lives of oflfspring. We have the solution in 
education, a well ordered scheme of which embracing the 
scientific application of physiology, biology and hygiene 
would be a plan of fundamental value in prevention. 
In the new school of prevention creative genius will pro- 
claim a way realistic in vitality, and any measure not 
in accord therewith will be relegated to the past. Along 
with this subject must be considered a matter of much 
importance: What shall we do with the dead? I do not 
doubt that tuberculosis and typhoid are distributed 
from our cemeteries through drainage. If all remains 
were cremated it would remove from civilization 
a great evil. In giving the question serious thought, 
we feel apprehensively interested in the outcome. 
The germs of some diseases such as those men- 
tioned, are so virile and tenacious that they can 
exist for years in our cemeteries and become dis- 
tributed to surrounding earth, and by force of capillar- 
ity be transported to some place where conditions would 
be favorable. They would multiply and eventually be 
carried to the home of man, taken into the system, and 
there manifest their presence by pathological results. 
Cremate the dead of all animal and all vegetable mat- 
ter that might prove a pabulum for sustaining germ life. 
By that means alone they can be destroyed. To study 
the subject of sanitation for its best results is a question 
of vital consequence. While it has its limits, it occupies 
a broad field as a factor in prevention. To consider 
the subject now from another standpoint : When culture- 
tests and the microscope demonstrate the presence of a 
transmissible disease steps should be taken to isolate the 
focus by international agreement. To prevent its 



286 OUTLOOK OF MEDICINE IB TOWARD PREVENTION. 

spread through commerce and travel. In the absence of 
such agreement, it would be well for each country where 
conditions might favor development of infection to adopt 
vigorous measures and guard against invasion by quar- 
antine or absolute non-intercourse with infected coun- 
tries, until the pest could be stamped out, and its ab- 
sence demonstrated to the tiatisfaction of pathologists, 
competent to pronounce judgment upon the conditions. 
The partial degree of success attending the lax methods 
heretofore employed demonstrates the possibility of ab- 
solute prevention, if all avenues of invasion ar^ guarded 
and nothing allowed to enter from infected districts. A 
sum equivalent to the means lost in trade disaster dur- 
ing one epidemic of yellow fever would defray the ex- 
pense of cleaning up the germ-breeding places of that 
scourge, and its eradication from the face of the earth ! 
A means will yet be demonstrated which will as certain- 
ly prevent yellow fever as vaccination does smallpox. 
Medical science is well equipped to grapple the subject 
— what we really need is international harmony and co- 
operation. We cannot impress the importance of pre- 
vention upon a people who are ignorant; therefore the 
first step is to educate the masses. Yet the perspective 
of education in its farthest possibilities is infinite. The 
more you educate mind the more it demands to know. 
Inquiry and research stimulate possibilities and open 
new fields for study ; it is a never-ending problem with no 
true solution in sight, therefore, we may expect progres- 
sive results without limit or cessation. The physician, 
chemist, and microscopist should be pioneers in the 
movement. The physician I know is ever ready to sacri- 
fice pecuniary advantage upon the altar of science, that 
the light of knowledge may continue to shine, shedding 
a halo of bright radiance over the field of inquiry, that 
research may find the jewel in the form of complete pre- 
vention of disease. While on this subject it 
would be well to allude to a vast crime which, next to 
consumption, is destroying more lives and souls than 
any other cause. I mean the liquor, opium, and cocaine 
traffic. A study of its insidious and loathsome results 
will convince anyone that it is a wide open door to de- 
struction. The physician is the proper one to call at- 
teention to the danger in these drugs as being destruct- 



RICHARD COOPBNDBR BAUKSTON. 287 

ive to digestion and nutrition. Upon our descendants 
the saddest blow falls, because the progeny of the drunk- 
ard is of poor vitality, inferior intellectually, and a dis- 
appointment generally ! It is not within the province of 
this paper to go into the criminology of drunkenness; 
yet it is a factor which must be eliminated to help i)er- 
fect the plan of prevention which will result in the im- 
provement of man and make him superior in future to 
the man of the present. But the pernicious liquor and 
drug traffic must cease to be an element in degenerating 
vitality and debasing mind. It is the greatest enemy 
to an improved posterity now known, except possibly 
the scourge, consumption, and its congener syphilis. 
Before I leave this subject I will ask my hearers to pon- 
der well. Try and help formulate a plan to prevent dis- 
ease from entering the body, that prevention may be dem- 
onstrated and posterity enjoy the blessing of a highly 
perfected life through our interest in their behalf. Shall 
w^e admit that progress is at an end in our present idea 
of prevention? No! let us never imagine that any high 
purpose or ndble thought is ever lost or ended. We may 
not witness its development, nor see it bloom forth in 
beauteous perfection, nor reap a rich harvest of result ; 
but when we have sown the seed, with knowledge of 
result wanted, then, may we gather the harvest of 
success. That fact accomplished the fondest hope 
of life will be realized. Do not fail to comprehend 
the true scope of this subject. Give it deep study and 
let us hope for favorable opinion that it may not be re- 
tarded by unscientific, illiberal criticism. It should at- 
tain popularity commensurate with its importance and 
be so closely studied that its value will impress wherever 
suggested. We are continually striving after new means 
-w^ith which to cure, when it is apparent to anyone giv- 
ing the subject cj^ref ul thought that changes will be con- 
stantly occurring because our methods are incorrect. 
What broad intelligence needs do is to habilitate preven- 
tion, and advance it as the means to accomplish results 
to which no foresight can predict an end. All physical 
phenomena are interesting. Their sublimity is not ob- 
scured by vague inception. Their finality, though shroud- 
ed in mystery, is important, and engages our considera- 



288 OUTLOOK OF MEDICINB IB TOWARD PREVENTION. 

tion to a greater extent that any subject known. It is of 
sneh general interest that we refer to it because we rea- 
lize it a barrier which must be overcome before we can 
progress further in our search for perfection. Cast oflP 
the serfdom of tradition — pull asunder the manacles 
which bind us to a past With faces turned toward the 
light of Twentieth Century knowledge looking eagerly for 
further advance, cry onward, upward, until achieve- 
ment will justify the claim that medicine as a science 
is above every other in the history of the world! 
Then the doctor, who stands today with lawyers, states- 
men and divines, will easily assume position above all, 
recognized as the guardian of life and steward of man's 
happiness, honored as leader by every avocation. Happy 
in that attainment, aspiration gratified, ambition satis- 
fied, enjoyment should be supreme. Let us feel the heart- 
throb of progress in the breast of humanity and know 
that a great harmony has been estalblished in prevention 
which will exist through all time as the true means of 
keeping that blessing — health — above every other at- 
tainment ! Let the silly irony of skeptics who hold that 
truth is variable be forever silenced, and in the concert 
of united effort let sophists sink to oblivion. I tell you 
earnestly the trend of events points to prevention as the 
route for future medical thought, and the characteris- 
tics of health will be our highest study. 

DISCUSSION. 

Dr. J. C . LeGrand : I have listened with interest to 
the paper, just read, and think the author has fully cov- 
ered the ground embraced by the subject. 

The suggestions contained in the paper are sound and 
valuable, and if carried into execution would result, I 
believe, in materially diminishing the cunount of disease 
in the country generally . 

No question possesses more of interest, or is entitled 
to more study than that of the prevention of disease, and 
it is in this field that progressive medicine is destined 
to win its greatest laurels. 

I arose only to endorse the sentiments expressed in the 
paper, and not for the purpose of attempting any discus- 
sion of it. 



DISCUSSION. 289 

Dr. J. H . Purif oy : If we had trained physicians in 
every country neighborhood, precinct, and county, of the 
State, it would be comparatively easy to limit the spread 
of infectious and contagious diseases. In the larger 
cities there are boards of health, whose duty it is to look 
after such matters, but in the country we have no such 
arrangement. We need in such places some one who 
has authority to act, and who will be sustained in the 
exercise of such authority. 

So far as the control of outbreaks of smallpox is con- 
cerned, we shall strike at the root of the matter by mak- 
ing vaccination compulsory. Whenever the entire popu- 
lation i« rendered immune to smallpox by vaccination, it 
will be impossible for an epidemic of that disease to pre- 
vail. 

As to the abuse of alcohol the surest prevention I 
know is for parents to set the example of temperance to 
their children. To preach temperance and practice in- 
temperance, or to indulge in even the moderate use of 
alcoholic drinks, will never cure the evil. Parents must 
be strong enough to set a good example to their chil- 
dren, and then by proper discipline they can enforce 
sound precepts. 

In regard to the cocaine and morphine habits, I am of 
the opinion that the profession is largely responsible for 
them. The hypodermic syringe is a very valuable instru- 
ment, and one we could scarcely do without, but it can 
be easily abused, and, in ray opinion, often is. 

The promptness with which it relieves pain is very 
seductive to patients, and, knowing the remedy used, they 
soon begin to resort to it without the advice of the doc- 
tor, and thus the habit becomes established. I repeat 
that the profession is responsible for many of these 
cases, consequently, one of the most potent ways of cur- 
ing the evil is for physicians to abstain from administer- 
ing such drugs, except when absolutely demanded, and 
then to keep the patient in ignorance of what is used. 
In harmony with the line of argument pursued by the 
author of the paper, I should like to see a vigorous and 
intelligent effort made to stamp out all infectious 
diseases, and believe that by such an effort much could 
"be accomplished. 

19 



290 OUTLOOK OF MEDICINE 18 TOWARD PREVENTION. 

Dr. E. T. Camp : The gentleman who read the paper 
said that the public should be educated on the subject of 
preventive medicine. I venture to say that many physi- 
cians need education along the same line. Many of 
them, I apprehend, fail to bear in mind the fact of the 
contagiousness of tuberculosis, when called upon to 
treat cases of that disease, and therefore neglect to en- 
force proper precautions to prevent others from becom- 
ing infected. 

When the gravity of this disease is borne in mind, 
such an oversight is highly culpable. Not only should 
proper precautions be observed to prevent tuberculosis 
from being propagated from a patient to others, but 
after the case has terminated, and often during its pro- 
gress, the premises and every article likely to have be- 
come infected should be thoroughly disinfected. This 
rule should apply not only to tuberculosis, but to small- 
pox, diphtheria, and all other infectious diseases. 

The question of the prevention of diseases possesses- 
great interest for me — hence I gave close attention to the 
paper and would like to see a campaign waged against 
disease in accordance with the propositions it lays down. 

Dr. W. H. Sanders : From some of the remarks made 
by the gentleman (Dr. Purifoy) who preceded the last 
speaker, the inference might be drawn that Alabama 
does not possess a public health system that extends into 
all parts of the State, into the remote country districts, 
as well as into the populous towns and cities. I desire 
to correct any such impression and to say that Alabama 
possesses a perfect and complete public health system 
that extends into every part of her territory, the machin- 
ery' of which can be set in operation in the remotest 
country district in the same way as in the most populous 
city of the State. Indeed, the system extends over all 
alike, and is absolutely uniform, both for country and 
city; that is, it consists of a harmonious and coherent 
whole, built up by means of uniform and symmetrical 
parts or units. 

The unit of the system is the county organization — one 
for each county — therefore, sixty-six for the State. In 
the absolute uniformity of these county organizations 
lies the strength and solidity of the system. They all 
fit together and therefore constitute a compact and co- 



DISCUSSION. 291 

herent whole, founded upon principles in thorough ac- 
cord with our system of government and logically built 
up from foundation to dome. 

Let us briefly analyze one of these sixty-six county 
organizations or units, and that will give us a clear and 
comprehensive view of the system, in so far as its public 
health function is concerned. 

To make the analysis more pointed, we will take this 
county, although the organization is, as said, the same 
in every countv of the State. 

First, a medical society exists in this county, to mem- 
bership in which every reputable physician in the county 
is eligible. This society is the board of health of the 
county, and is endowed by law with certain legal and 
public health functions. It is not simply a body of 
physicians voluntarily united for scientific and social 
purposes, but much more than this — a. county board of 
health, upon which devolves the responsibility of pro- 
tecting the health of the people of the remotest country 
neighborhood of this county, as well as of this city. 
There are about thirty members of this county board of 
health, a body obviously too large to act promptly when 
an outbreak of infectious disease occurs. To meet 
this difficulty the board of health provides a com- 
mittee of public health, composed of five of its oldest 
and most trusted members, w^hose duty it is to exercise 
general supervision over the sanitary interests of the 
county, and especially to be on the alert for the first ap- 
pearance of infectious disease of any kind. 

The county board of health or county society also 
elects a county health officer, whose jurisdiction extends 
to the remotest corners of the county, and whose esi)ecial 
duty it is to look after the country districts — the very 
part of the county which the doctor supposed to be un- 
provided with health machinery. The cities, and many 
of the larger towns, employ health officers of their own, 
hence, the health officer of the county is relieved of all 
responsibility so far as such cities and towns are con- 
cerned, and can, therefore, devote more of his time to the 
country districts. 

The committee of public health, composed of five doc- 
tors ; the county health officer ; and the city and town 
health officers of any municipalities that employ such 



292 OUTLOOK OF MEDICINE 18 TOWARD PREVENTION. 

officers, constitute the active medical authorities for 
protecting the health of the people of this county, both 
in the country and the towns. 

Now, to control outbreaks of infectious disease two 
things are required: Skill and money. The doctors 
are expected to furnish the former ; the county and mu- 
nicipal authorities, the latter. Both must do their part, 
in order to maintain an efficient public health system. 

The doctors of this State and of this county have long 
signified their willingness to do their part, hence, it only 
remains for the county and municipal authorities to do 
theirs, that is, to furnish the money. Wherever the 
authorities have done this, Alabama's system of public 
health has been operated with conspicuous success, but 
where they have done it imperfectly, or not at all, the 
work of controlling outbreaks of infectious disease has 
been more or less imperfectly done, or not at all. 

Here lies the secret of any apparent failure of the 
public health system of Alabama, the authorities of the 
locality where the failure appeared to exist declined to 
furnish the necessary money. Obviously, disease can no 
more be suppressed without the expenditure of money 
than crime can be. Money is just as essential for car- 
rying into execution public health measures as for hold- 
ing courts to try criminals and to enforce law and order. 
In this connection attention is called to the fact that the 
public health system of Alabama is not only logical and 
complete, but is formulated upon wonderfully economi- 
cal principles. It exacts more or less work from all of 
the doctors of the State, and a great deal of work from 
the State and county committees of public health, for 
which no renumeration whatever is either asked or re- 
ceived. The only salaries the system provides for is one 
from the State for the State Health Officer, and one from 
each of the counties for their respective health officers. 

The key to the situation at present consists in provid- 
ing adequate salaries for the county health officers, and 
adequate appropriations for enforcing such public health 
measures as the committees of public health of the sev- 
eral counties may recommend. Some counties have dis- 
charged their duty in these respects and in them out- 
breaks of smallpox and other infectious diseases have al- 
ways been promptly controlled, but other counties have 
failed to appropriate the necessary funds, consequently, 
smallpox has continued to prevail in such counties and 



DISCUSSION. 29S 

they have remained as foci for the distribution of the 
disease. 

Whilst smallpox has prevailed extensively in this 
State for the past four years, or more, yet, at any time 
within that period the disease could have been entirely 
exterminated within sixty days, or less. To accomplish 
this result, it was only necessary for all of the counties 
in which the disease was prevailing to simultaneously 
wage war upon it. This, the doctors would have done 
had they been furnished with the means. 

The responsibility, therefore, for the failure to sup- 
press smallpox does not rest upon the doctors, but direct- 
ly upon the authorities who should have furnished the 
means, and indirectly upon the law-makers of the State 
for their failure to enact a law making it mandatory on 
the commissioners of the several counties to appropriate 
adequate salaries for their respective health officers, and 
also the failure of the law-makers to enact a law of com- 
pulsory vaccination. 

But, I only undertook to defend Alabama's public 
health system, and to show that any apparent lack of 
efficiency in it is due, not to inherent defects, but to lack 
of means for carrying it into execution. 

No better system could possibly be devised for follow- 
ing out the broad principles for the prevention of disease 
laid down by the author of the paper, now undergoing 
discussion. Before taking my seat, I desire to warmly 
endorse one of the many sound propositions he laid 
down, namely, that we must continue to educate the pub- 
lic upon the great principles of preventive medicine, and, 
although our progress may seem slow, in the end we will 
undoubtedly achieve much. 

Dr. T. A. Casey : No more important subject will be 
presented to this Association than the one now under 
discussion. The prevention of disease is a science, and 
should be taught in all high schools and colleges where 
young men and women are being educated. Doctors 
should use their influence in this direction, for it is a 
field in Avhich much good may be accomplished. 

It is my purpose to present a paper during the meeting 
covering much the same subject, it being one in which 
I am greatly interested. 

Dr. L. E. Starr : One of the great difficulties of regu- 
lating the sanitary affairs of our State lies in getting the 



294 PERNICIOUS VOMITING OF PREGNANCY. 

proper laws passed. Now, I believe that a large ma- 
jority of our legislators can be influenced by members of 
this Association, if we approach them at the proper time 
and in the proper manner. 

I have never failed to interest the legislators of my 
county, nor to get them to assist in everything we asked. 
If we approach theai in the right way, I believe we can 
get any law passed we want. 

Dr. E. C. Parker : One important thing in the preven- 
tion of disease is the prompt report of all cases of infec- 
tious disease. Such cases should be reported as soon as 
recognized. Doctors often make the mistake of delaying 
such reports, and thus allowing time for the disease to 
spread. In smallpox prompt isolation of the patient, 
and vaccination of those exposed, will always cut short 
an outbreak. In suspected tuberculosis the sputa should 
be examined, and if the suspicion is confirmed all precau- 
tions should be taken to prevent others from becoming 
infected. 



THE PERNICIOUS VOMITING OF PREGNANCY. 



By Matthew Buntan Cameron, M. D., Sumtebville. 
Senior CounseUor of the Medical Association of the State of Alabama. 



In the discussion of this subject I shall consider only 
that form of hyperemesis which is persistent, grave, and 
in which the stomach seems rebellious to every fluid or 
solid ingested. 

We have in almost every pregnancy a mild type of 
vomiting and morning sickness, that yields readily to 
hygienic or medicinal treatment, but the prenicious type 
of vomiting is a disease so rare that its existence has 
been denied by some noted men in the profession. 

Hohl, of Germany, denied the existence of the affec- 
tion, and Carl Braun in an experience of one hundred 
and fifty thousand obstetrical cases never saw a fatal 
termination. The experience of American, English, and 
French physicians has been quite contrary to this, as 



MATTHEW BUNYAN CAMERON, 295 

Doe, of this country, collaborated 48 cases, with 18 
deaths; while Geuniot records 118 cases, with 46 deaths; 
which is quite an appalling mortality. 

Recently three cases of this disorder have come under 
my observation, one of which recovered under the admin- 
istration of drugs, the production of abortion saved an- 
other, while the third died from exhaustion and toxae- 
mia, because consent for operative interference was de- 
layed too long to be effectual. This experience has led 
to the preparation of this paper, with the hope of di- 
recting the attention of the profession to a serious 
malady in which surgical relief is often too long de- 
layed. The etiology of this trouble is shrouded in mys- 
tery, and there appears to be no definite consensus of 
opinion as to its causation. 

In all three of my cases there was a highly sensitive 
nervous system. One was a hystero-epileptic, suffering 
with repeated attacks, often of long duration, with a 
grand ancestor choreic in the extreme. 

Another was hypochondriacal, with frequent hysteri- 
cal manifestations and a decided vaginismus. The third 
case was a negress, with a nervous system much more 
impress^ionable than is generally seen in women of her 
race. This leads me to believe that women of the hysteri- 
cal type are much more prone to this trouble than those 
with healthy nervous systems. 

Graily Hewitt was long ago led to believe that uterine 
displacements were fruitful in producing this affection. 
His idea was that the nerves of the cervical ganglion 
were pinched at the angle of flexure, or compressed by 
the inflammatory changes in the form of the ^'omb. As 
a matter of fact we know that pathological positions of 
the uterus are productive of nausea and vomiting in a 
non-gravid state, especially when there is an inflamma- 
tory condition. Hence, it is easy to suppose that the 
additional excitant of pregnancy would intensify the 
pre-disposition to this trouble. 

Twombley has recently reported a fatal case which il- 
lustrates the fact that displacements and faulty posi- 
tions of the pregnant uterus, retarding its rising up out 
of the cavity of the pelvis and pressing upon the cervix, 
are more often the cause of excessive vomiting than has 
been generally supposed. 



296 PERyicious vomiting of pregnancy. 

H. S. Knight reports a case^ rapidly progressing to a 
fatal termination, which was relieved by the correction 
of an anteflexion by a soft rubber pessary, and by pack- 
ing the vagina. 

^•. P. Davis supports this etiological factor in a recent 
contribution to the American Journal of Obstetrics. 
He says that "in a considerable number of these cases 
the uterus is sharply anteflexed and the cervix greatly 
thickened. In other cases the womb is retroflexed or 
retroverted." 

While acknowledging that displacements are often 
coexistent with pernicious vomiting, and appear to be 
causative, yet, it must be only as contributory factors 
that they twang the tense chords of the neurotic. 

In the cases I have seen, and in those of many others 
who have contributed to the literature of the subject, no 
abnormal position of the uterus was detected ; therefore 
such cannot be accepted as the sole factor in the causa- 
tion of pernicious vomiting. J. H. Bennett has directed 
attention to pathological conditions of the vaginal por- 
tion — inflammatory states, and especially excoriations 
and erosions of the external os — in their causal relation 
to this disorder. The great relief sometimes experienced 
from local treatment of erosions, and by divulsion of the 
cervix, appears to bear out this idea. One of my cases 
had previously passed through her first pregnancy with- 
out much discomfort from nausea. In her second preg- 
nancy she had pernicious vomiting from the second 
month. Upon the introduction of the speculum for the 
purpose of dilating the cervix, the os w^as found very 
much eroded and inflamed. Local treatment and dila- 
tation of the cervix gave almost complete relief until an 
attack of influenza, attended by a severe otitis media, re- 
established the trouble, with all its distressing severity. 

Some investigators have by examination of the blood 
in this condition established the fact that there is a pro- 
found toxaemia. The red blood corpuscles are dimin- 
ished in number, and there is a decided leucocytosis ; the 
urine often presenting evidence of intoxication by its 
high color, speciflc gravity, and the presence of albumen. 
Evidently the toxins, whatever may be their nature, are 
absorbed from the intestinal canal, circulate in the 
blood, and manifest a great aflSnity for the vomiting 
center in the medulla. This vomiting center has been lo- 



MATTHEW BUNYAN CAMERON. 297 

cated by Tumas, from experiments on dogs and cats, "ia 
a small space before and behind the calamus, and in the 
deep layers of the medulla, near to or in close communi- 
cation with the center which, by inference, presides over 
the organs of generation." 

Here we have a double reflex action from the two cen- 
ters involved, the one by its action on the nervous sys- 
tem, producing the hyper-emesis, the other, through its 
reflex action on the uterus, tending to increase the pro- 
duction of the toxaemic substances. 

Intra-pelvic pressure is evidently sometimes respon- 
sible for this trouble, as it very often subsides when the 
uterus rises out of the cavity of the pelvis. Whether thia 
be from the effect on the nervous or circulatory systems, 
it would be hard to decide. 

Pressure upon the nerves would very probably excite 
an already intense neurotic condition and cause an ex- 
plosion. 

Monin believes that this disorder is due to abnormal 
gastric secretions, and treats his cases very successfully 
with bicarbonate of soda. 

A pre-existent gastritis, or gastric ulcer, or an intes- 
tinal catarrh, is doubtless aggravated by the puerperal 
state, but these conditions could hardly be considered as 
originating the trouble. 

The diagnosis of pernicious vomiting of pregnancy is 
apparently easy, but in reality it is sometimes very diffi- 
cult. A positive conclusion that pregnancy exists must 
be reached^ through bimanual examination and other iur 
vestigations. 

No opinion should be expressed and no treatment insti- 
tuted until this has been done. If satisfied on this point 
there are still to be eliminated some other pathological 
conditions, whose co-existence might occasion the obstin^ 
ate vomiting. Cazeaux gives the history of a fatal case 
of alleged hyperemesis of pregnancy in which the 
autopsy disclosed tubercular peritonitis and the absence 
of pregnancy. 

Trousseau induced abortion in a case in which the 
autopsy revealed cancer of the stomach. 

Beaux made a similar mistake in a case the autopsy 
of which showed tubercular meningitis . Cancer of the 
liver has sometimes been accompanied by this persist- 
ent vomiting. The special diagnostic features of all' 



296 PERNICIOUS VOMITING OF PREGNANCY. 

H. S. Knight reports a case, rapidly progressing to a 
fatal termination, which was relieved by the correction 
of an anteflexion by a soft rubber pessary, and by pack- 
ing the vagina. 

^' P. Davis supports this etiological factor in a recent 
contribution to the American Journal of Obstetrics. 
He says that "in a considerable number of these cases 
the uterus is sharply anteflexed and the cervix greatly 
thickened. In other cases the womb is retroflexed or 
retroverted.'' 

While acknowledging that displacements are often 
coexistent with pernicious vomiting, and appear to be 
causative, yet, it must be only as contributory factors 
that they twang the tense chords of the neurotic. 

In the cases I have seen, and in those of many others 
who have contributed to the literature of the subject, no 
abnormal position of the uterus was detected ; therefore 
such cannot be accepted as the sole factor in the causa- 
tion of pernicious vomiting. J. H. Bennett has directed 
attention to pathological conditions of the vaginal por- 
tion — inflammatory states, and especially excoriations 
and erosions of the external os — in their causal relation 
to this disorder. The great relief sometimes experienced 
from local treatment of erosions, and by divulsion of the 
cervix, appears to bear out this idea. One of my cases 
had previously passed through her first pregnancy with- 
out much discomfort from nausea. In her second preg- 
nancy she had pernicious vomiting from the second 
month. Ui)on the introduction of the speculum for the 
purpose of dilating the cervix, the os was found very 
much eroded and inflamed. Local treatment and dila- 
tation of the cervix gave almost complete relief until an 
attack of influenza, attended by a severe otitis media, re- 
established the trouble, with all its distressing severity. 

Some investigators have by examination of the blood 
in this condition established the fact that there is a pro- 
found toxaemia. The red blood corpuscles are dimin- 
ished in number, and there is a decided leucocytosis ; the 
urine often presenting evidence of intoxication by its 
high color, specific gravity, and the presence of albumen. 
Evidently the toxins, whatever may be their nature, are 
absorbed from the intestinal canal, circulate in the 
blood, and manifest a great aflSnity for the vomiting 
center in the medulla. This vomiting center has been lo- 



MATTHEW BUNYAN CAMERON. 297 

cated by Tumas^ from experiments on dogs and cats, ^4a 
a small space before and behind the calamus^ and in the 
deep layers of the medulla, near to or in close communi- 
cation with the center which, by inference, presides over 
the organs of generation. '^ 

Here we have a double reflex action from the ti;^^o cen- 
ters involved, the one by its action on the nervous sys- 
tem, producing the hyper-emesis, the other, through its 
reflex action on the uterus, tending to increase the pro- 
duction of the toxaemic substances. 

Intra-pelvic pressure is evidently sometimes respon- 
sible for this trouble, as it very often subsides when the 
uterus rises out of the cavity of the pelvis. Whether this 
be from the effect on the nervous or circulatory systems, 
it would be hard to decide. 

Pressure upon the nerves would very probably excite 
an already intense neurotic condition and cause an ex- 
plosion. 

Monin believes that this disorder is due to abnormal 
gastric secretions, and treats his cases very successfully 
with bicarbonate of soda. 

A pre-existent gastritis, or gastric ulcer, or an intes- 
tinal catarrh, is doubtless aggravated by the puerperal 
state, but these conditions could hardly be considered as 
originating the trouble. 

The diagnosis of pernicious vomiting of pregnancy is 
apparently easy, but in reality it is sometimes very diffi- 
cult. A positive conclusion that pregnancy exists must 
be reached^ through bimanual examination and other in- 
vestigations. 

No opinion should be expressed and no treatment insti- 
tuted until this has been done. If satisfled on this point 
there are still to be eliminated some other pathological 
conditions, whose co-existence might occasion the obstin- 
ate vomiting. Cazeaux gives the history of a fatal case 
of alleged hyperemesis of pregnancy in which the 
autopsy disclosed tubercular peritonitis and the absence 
of pregnancy. 

Trousseau induced abortion in a case in which the 
autopsy revealed cancer of the stomach. 

Beaux made a similar mistake in a case the autopsy 
of which showed tubercular meningitis. Cancer of the 
liver has sometimes been accompanied by this persist- 
ent vomiting. The special diagnostic features of all' 



298 PERNICIOUS VOMITING OF PREGNANCY. 

these diseases should be carefully sought for before, by 
their elimination, we may rest secure in the correctness 
of their diagnosis. 

The treatment of this serious disorder is befogged by 
all the myths of empiricism. The long list of remedies 
for it, arrayed in the text books, is suggestive of their 
futility. The procedures recommended may be classi- 
fied as hygienic, medicinal, and surgical. 

Hygienic management is beyond doubt of great im- 
portance and upon the strict observance of the rules laid 
down by the physician for the control of the patient's 
exercise, diet, and surroundings, the termination to a 
great degree depends. Absolute rest in a darkened room 
is desirable, and the head should be on a lower plane 
than the body. It should not be raised even to take 
water, nourishment, or medicines, but they should be ad- 
ministered through feeding tubes. Perfect quiet should 
be enjoined. No inquiring friends should be admitted, 
and the absence of meddlesome mothers who have gone 
through mild cases of morning sickness is especially 
desirable. 

The diet should be of a liquid character, such as pep- 
tonized milk, or beef juice, in conjunction with lime- 
water. 

When this is constantly rejected and the nausea and 
retching are unintermittent, we are obliged to resort to 
rectal feeding in order to support the much-needed vital 
powers. From two to four ounces of peptonized milk at 
the temperature of the body should be administered per 
rectum every four to six hours. 

Peptonized milk given in this way has proved quite 
satisfactory in my experience. I have succeeded, by its 
use, in sustaining the strength of a patient for nearly 
four weeks. It requires considerable perseverance and 
tact to properly feed a patient by the rectum for a long 
time, and wherever the conditions will admit, the aid of 
a trained nurse will be very valuable. The enemas should 
be given high up in the rectum, through a soft rubber 
catheter of large size. The patient should be in the 
Simms' position, and the anus should always be com- 
pressed for a few minutes after the \sithdrawal of the 
^catheter. 

The syringe should be of hard rubber with a cylinder 
of about four ounces capacity. The condition of the skin, 



MATTHEW BUNYAN CAMERON, 299 

kidneys, and bowels should be closely watched and ap- 
propriate measures employed to remedy the least de- 
ficiency of action in either. 

In the administration of drugs for the relief of this 
trouble we are almost certain to meet \vith disappoint- 
ment, nx) matter what therapeutic route we travel. Car- 
bolic acid, bismuth, cocaine, oxalate of cerium, nux 
vomica, pepsin preparations, the much-vaunted ingluvin, 
and a host of other remedies have all failed in my hands. 
In hyperemesis of moderate degree they seem to have a 
curative effect, but in prenicious vomiting they are not 
only useless but aggravating. Chloral and potassium 
bromide are the only drugs that I have found to merit 
employment. One of my cases gradually improved 
under their administration, and finally recovered when 
I was on the point of emptying the uterus. They should 
he given combined, by the mouth, if possible, but, if not 
retained, the dose should be mixed with starch ^vater or 
glycerin and administered as an enema. Subcutaneous 
saline injections are highly recommended by Bacon, 
upon the ground that they dilute the blood, increase 
vascular tension, and eliminate toxins through the renal 
and intestinal emunctories. In cases of purely toxaemic 
origin such treatment should be ideal. It should always 
be used as a preliminary measure to the rapid emptying 
of the uterus where there is a marked degree of weakness 
or emaciation. Washing out the stomach may, also, be 
tried in the earlier stages of the disease. J. P. Oliver, in 
a recent publication, reports the relief of a serious case 
by electricity. He used the positive and negative poles, 
alternately, up and down the spinal column and over the 
fltomach. 

I desire to warn the profession against the use of mor- 
phine in this trouble. It is a delusion and a snare; a de- 
lusion, because the relief is temporary and fleeting; a 
snare, in that it induces you to continue its use, hoping 
for better things, until you have frittered away a life 
that the surgeon's art would have promptly saved. 
Twice, I have been lured into its employment, yielding, 
with protests, to the appeals of patients who refused to 
permit surgical intervention. In one case death closed 
the scene; the other consented to an operation after 
weeks of opposition, and is now fighting the great battle 
for recuperation, won by very few. I believe it is the 



300 PERNICIOUS VOMITING OF PREGNANCY. 

duty of a physician, when, in his opinion, seconded by 
that of a competent consultant, the case calls for the in- 
duction of abortion and the advice is rejected by the 
patient in the hope that she may be tided over the emer- 
gency by morphine, to promptly retire from the case. 

We now come to the surgical treatment of this dis- 
order. 

First, all uterine displacements should be sought for 
and corrected. 

This must be done in the most gentle manner possible. 

The soft rubber pessary, with thorough packing of the 
vagina, will be as harsh means as we are justified in 
using. The treatment of erosions with pure carbolic acid 
and iodine, and by means of vaginal flushings with hot 
water, is often beneficial. The divulsion of the cervix^ 
about one inch antero-posteriorly and half an inch later- 
ally, has often, in some hands, been entirely remedial. 
But there are cases that show no relief from the employ- 
ment of any or all of these measures. The retching and 
vomiting continue, the rectal food is expelled or is insuf- 
ficient to sustain the strength of the patient, the pulse 
grows rapid and w^eak ; the respirations are too frequent, 
albumen is often present in the urine, and progressive 
emaciation appears. 

Confronted with such a condition, the physician has 
to deal with the most serious problem, the gravest re- 
sponsibility, to which a member of the profession can be 
subjected. He must rise to that heroic devotion to duty 
which will compel him to advise the sacrifice of the life 
of the unborn child to save that of the mother, or he 
must sink into a criminal apathy that will surely cause 
the death of both. There are some who hold that the 
production of abortion is never justifiable in this trouble. 
They seem to think that because some, after being despe- 
rately ill, recover without operation, all will do so. They 
ignore the record of numerous deaths from pernicious 
vomiting that annually occur. 

Bacon says : "The production of abortion is never in- 
dicated, for w^hen it is safe and effectual it is not neces- 
sary, and in extreme cases it adds greatly to the dan- 
ger." If he had been in charge of two of my cases I 
would with reluctance be the bearer of his conscience. 

It is criminal to wait until the patient is moribund 
before resorting to the operation. When neither the 



MATTHEW BUKYAN CAMERON. 301 

stomach nor rectum will retain food, and the pulse con- 
tinues over 110 ; when there is much emaciation and pro- 
found alterations in the blood, the uterus should be 
promptly emptied. 

How shall the uterus be emptied? 

In those cases where there is enough vitality to ren- 
der it safe the rapid method is to be preferred. Under 
the strictest aseptic conditions, the patient being chloro- 
formed, the cervix is widely dilated with steel dilators, 
the foetus and membranes are removed with the fingers 
or with instruments, and the decidua scraped away with 
the sharp curette. 

The uterus should then be washed out with sterilized 
hot water, and thoroughly packed with iodoform gauze. 
The gauze should be removed within fourteen hours and 
the vagina douched with an antiseptic solution. When 
there is marked depression the slow method is better. 

My way of doing this is to slightly dilate the cervix, 
rupture the membranes, and introduce within the womb 
a soft rubber catheter that has been boiled for fifteen 
minutes ; then, securely pack the vagina to guard against 
hsBmorrhage. Usually, upon removal of the packing 
twenty-four hours later the foetus will be found expelled. 
By rupturing the membranes you seem to save your pa- 
tient much pain that would ensue if they were left intact. 
If all the placental and deciduous mass is not thrown off 
at the time the foetus and membranes are expelled the 
vagina must be kept packed, and ergot given until the 
uterus is thoroughly empty. Delay is dangerous, and I 
appeal to the profession to come at once to the rescue of 
the woman when the danger signals are hoisted, and not 
wait until the lamentable catastrophe becomes un- 
avoidable. 

DISCUSSION. 

Dr. E . B . Ward : I can not let this important sub- 
ject pass without making some remarks upon it. 
I do not intend to discuss the medicinal treat- 
ment of the affection, for I claim that this kind 
of treatment often results in failure and leads 
to delay, when such is dangerous. As I understood the 
reading of the paper it was the i)erniciou8 form of vom- 
iting that was dwelt upon. How often are we confronted 
by these formidable cases and look anxiously to the 



302 PERNICIOUS VOMITING OF PREGNANCY, 

materia medica for help only to be disappointed ! Dilata- 
tion of the cervix, application of iodine to the os, cauter- 
ization of cervix, all of these have been tried with poor 
success. I claim that the only safe and certain cure for 
these rebellious cases is in the hands of the gynecologist, 
and consists in emptying the womb. Of course, I do not 
mean to convey the impression that I would not try me- 
dicinal treatment in the outset, before the symptoms be- 
come grave; these failing^ I would without delay resort 
to surgical interference. The reason why so many of 
these cases terminate fatally is that we fail to recognize 
the necessity for interference until it is too late. We 
should exercise our own judgment and good common 
sense, meet the emergency face to face, recognize its 
gravity, and act accordingly. Do not wait until the 
strength of the patient is fast leaving her, her life slowly 
ebbing, before you resort to this operation. If this is 
done in time the relief is immediate and certain, and at- 
tended with very little danger. A prompt induction of 
abortion when done suflBciently early is always attended 
with success. Very properly we all shrink from the idea 
of destroying an unborn babe, and condemn in the 
strongest terms the indiscriminate induction of abortion. 
But, in these grave cases we have no time to moralize, 
the life of the mother is at stake. Should we then per- 
mit her life to be sacrificed upon puritanical ideas or 
strained conscientious scruples? By surgical interfer- 
ence, I mean the rapid dilation of the cervix with steel- 
dilators and the thorough emptying of the uterus with 
the sharp curette, we can save the lives of these patients. 
I do not favor the slow process of dilatation with 
tents, or the packing of the cervical canal with 
gauze. This is too dilatory. Proceed at once to the use 
of the curette, after rapid dilatation. One authority 
states that the indications for this procedure are: When 
tlie patient shows signs of exhaustion, as manifested by 
rise of pulse to 115 to 120 and the vomited matter 
becomes dark brown or blackish. It is not always 
necessary to put the patient under a general anaesthetic 
to curette. I have often by the administration of morphia 
and strychnia hypodermically obviated the risk of giving 
chloroform. I would say that there is no excuse for let- 
ting these cases die, when, during this era of advanced 
gynecological practice, we can resort to an absolute 
measure of relief which, when applied with perfect 



DISCUSSION. 30a 

aseptic technique, is free from all danger. Act promptly, 
then, and you will save your patient ; delay and tempor- 
ize with drugs, and death will often claim a victim. 

Dr. W. G. Harrison: I wish Dr. Ward had read his 
paper on "Keflex Neuroses in Women" right here, as I 
believe there is a close connection between that subject 
and the one now under discussion. In my opinion the 
pernicious vomiting in pregnancy is caused by a dis- 
placement of the womb. 

I regard hypodermoclysis as a valuable remedy for 
thifi distressing trouble, and have used it in several cases 
with decided benefit, and have seen reports of its good 
effect when used by others. I feel justified in recom- 
mending it to the members of this Association as a rem- 
edy worthy of trial. 

Dr. B. G. C!opeland : I notice that the essayist men- 
tioned a number of various remedies for pernicious 
vomiting. All of them are good, but I notice that really 
up to the present date there is absolutely not one new 
idea advanced. I know of none. You find the same old 
carbolic acid, bismuth, and soda. It strikes me that if 
there was so much attention to be paid to this one trouble 
that our more recent text books would point out this. 
When there is nausea and it becomes alarming, the idea 
is to empty the womb. When a woman suffers with 
nausea, a hypodermic of morphine will not help her. 
With pernicious vomiting I should not hesitate to bring 
on an abortion, but I should like to have the benefit of 
consultation before I did it. We should certainly sacri- 
fice the life of the one that really never existed rather 
than the life of the mother, and I should not wait too 
long. I know of several cases where the result has been 
fatal, and the families blamed themselves for the final 
termination. I should dilate the womb and by observing 
all the precautions you can control the hemorrhage. Of 
course every doctor should first ascertain the cause of 
the nausea, which is generally due to the pressure of the 
child. 



304 PERNICIOUB VOMITING OF PREGNANCY. 

Dr. Cameron (closing) : In my paper I simply under- 
took to discuss the subject of Pernicious Vomiting in 
Pregnancy, and did not undertake to point out the dif- 
ferential diagnosis <betwixt that affection and vomiting 
that might occur in cancer of the stomach. Of course 
the two affections might coexist in the same patient. 
Further, pregnant women might be greatly troubled 
with vomiting due to brain disease, or to some other af- 
fection ; that is, cases arise in which the attending physi- 
cian could not come to a positive conclusion as to the 
cause of the vomiting. As said, it did not come within 
the scope of my paper to deal extensively with the subject 
of differential diagnosis. Neither did my paper refer to 
the modified form of vomiting in which the patient has 
spells of vomiting in the morning, which, although more 
or less troublesome, do not constitute pernicious vomit- 
ing. 

Whenever a physician has a case of the latter kind 
under his charge and makes up his mind that nothing 
short of emptying the womb will save the life of the 
woman, and so advises the patient and her friends, if his 
advice is disregarded, he should withdraw from the case 
and let another physician be called. If the second phy- 
sician gives the same advice, and insists upon it, the lady 
and her friends will be more apt to follow the advice than 
when given by the first attendant. 



ANDREW McADAJdS BTOVALL. 305 



THERAPEUTIC USES OF WATER. 



By Andrew McAdams Stovall, M. D., Jaspeb, Ala. 

Orand Senior Counsellor of the Medical Association of the State of 

Alabama. 



Hydrotherapeutics may be defined as the method of 
applying water for the relief or cure of disease. 

It includes the application of water in any form as 
solid, fluid, or vapor ; from ice to steam, internally or ex- 
ternally. Some seem to think that Hydrotherapeutics is 
only the use of cold water. 

In the form of steam it has a styptic action ; and the 
aseptic uses of hot Avater in surgery, with its resorbent 
effects in gynecology and surgery, are well known. 

Its application in gastric, rheumatic, and intestinal 
troubles and in meningitis, render hot water as impor- 
tant a hydriatric agent as cold water. 

The origin and growth of hydrotherapy form one of 
the most interesting chapters in the history of medicine. 
They illustrate how prejudice may thwart progress and 
how enlightened physiology and pathology have tended 
to reinstate a valuable but neglected remedy. 

I will first consider the general effect of water, when 
introduced into the system. The importance of water 
for the maintenance of the human organism is a w^ell- 
known physiological fact. It not only furnishes a solvent 
for the elements required in the life and functions of 
the tissues, but it serves to maintain that degree of ten- 
sion which is required for the proper circulation of the 
lymph stream. 

Glax has furnished the most recent investigations on 
the subject. 

The pulse is affected according to the temperature of 
the water taken, cold water reducing the frequency by 
from six to thirtv beats. 

He has seen a reduction in the pulse from 80 to 49 
beats from the drinking of 45 oz. of water at 43 degrees 
20 



304 PERNICIOUS VOMITING OF PREGNANCY. 

Dr. Cameron (closing) : In my paper I simply under- 
took to discuss the subject of Pernicious Vomiting in 
Pregnancy, and did not undertake to point out the dif- 
ferential diagnosis betwixt that affection and vomiting 
that might occur in cancer of the stomach. Of course 
the two affections might coexist in the same patient. 
Further, pregnant w^omen might be greatly troubled 
w^ith vomiting due to brain disease, or to some other af- 
fection ; that is, cases arise in which the attending physi- 
cian could not come to a positive conclusion as to the 
cause of the vomiting. As said, it did not come within 
the scope of my paper to deal extensively with the subject 
of differential diagnosis. Neither did my paper refer to 
the modified form of vomiting in which the patient has 
spells of vomiting in the morning, which, although more 
or less troublesome, do not constitute pernicious vomit- 
ing. 

Whenever a physician has a case of the latter kind 
under his charge and makes up his mind that nothing 
short of emptying the womb will save the life of the 
woman, and so advises the patient and her friends, if his 
advice is disregarded, he should withdraw from the case 
and let another physician be called. If the second phy- 
sician gives the same advice, and insists upon it, the lady 
and her friends will be more apt to follow the advice than 
when given by the first attendant. 



ANDREW McADAMS 8T0VALL. 395 



THERAPEUTIC USES OF WATER. 



Bt AI7DBEW McAdams Stoyaix, M. D., Jasper, Ala. 

Orand Senior Counsellor of the Medical Association of the State of 

Alabama. 



Hydrotherapeutics may be defined as the method of 
applying water for the relief or cure of disease. 

It includes the application of water in any form as 
solid, fluid, or vapor ; from ice to steam, internally or ex- 
ternally. Some seem to think that Hydrotherapeutics is 
only the use of cold water. 

In the form of steam it has a styptic action ; and the 
aseptic uses of hot Avater in surgery, with its resorbent 
effects in gynecology and surgery, are well known. 

Its application in gastric, rheumatic, and intestinal 
troul>les and in meningitis, render hot water as impor- 
tant a hydriatric agent as cold water. 

The origin and growth of hydrotherapy form one of 
the most interesting chapters in the history of medicine. 
They illustrate how prejudice may thwart progress and 
how enlightened physiology and pathology have tended 
to reinstate a valuable but neglected remedy. 

I will first consider the general effect of water, when 
introduced into the system. The importance of water 
for the maintenance of the human organism is a well- 
known physiological fact. It not only furnishes a solvent 
for the elements required in the life and functions of 
the tissues, but it serves to maintain that degree of ten- 
sion which is required for the proper circulation of the 
lymph stream. 

Glax has furnished the most recent investigations on 
the subject. 

The pulse is affected according to the temperature of 
the water taken, cold water reducing the frequency by 
from six to thirty beats. 

He has seen a reduction in the pulse from 80 to 49 
beats from the drinking of 45 oz. of water at 43 degrees 

20 



306 THERAPEUTIC U8E8 OF WATER. 

Fy this being drunk in doses of 9 oz. at intervals of thirty 
minutes. 

Warm water increases the pulse by from ten to six- 
teen beats. The character of the pulse is aflfected by the 
drinking of large quantities of water. 

Glax says the changes in the pulse ensue too quickly 
after the drinking of water of different temperatures to 
be the result of an increase of water in the blood ; they 
are therefore very probably the result of a reflex action 
upon the vaso-motor centers. The latter eflfect was ac- 
tually demonstrated by the experiment of Spallitia and 
Tomasini, who found after the inhibition of cold water 
a narrowing of the cutaneous vessels. 

It may, therefore, be stated with some degree of posi- 
tiveness that the internal use of cold and of warm water 
has a definite influence upon the vaso-motors not unlike 
that produced by their external application. 

The diuretic eflfect of water does not depend upon the 
amount imbibed, as is erroneously supposed, but rather 
upon an increase of blood pressure produced by the irri- 
tant action of the cold and the consequent increased 
rapidity of the blood streams in the kidneys . For this 
reason the diuretic effect is absent when the water is 
drunk luke-warm or when the heart is not sound. Hot 
water, having the same irritant action, produces the 
diuretic effect. 

From the above mentioned physiological facts with re- 
gard to cold, warm, and hot water, Avhen taken into the 
stomach, the application in disease is evident. 

When cold water is taken into the stomach its pri- 
mary effect will depend entirely upon the condition of 
the alimentary canal and the constitutional state of the 
person who takes it. 

In the majority of healthy individuals, if not all, the 
stomach in the morning and before taking food is con- 
tracted so as to present the appearance of a tube, the 
inner walls of whi^h are so nearly in contact that its 
caliber is considerably less than the small intestine, ex- 
cept when the latter is extremely contracted. 

The tubular stomach curves obliquely downward and 
to the right from the cardiac to the pyloric oriflce. 

Under this condition the water will run directly 
through into the small intestine, its only effect being by 



ANDREW McADAMS STOVALL. 307 

the sudden chill to exert some influence on the tone of 
the blood vessels and the gastric mucus coats while wash- 
ing through whatever mucus or particles of food that do 
not cling to the walls of the stomach, and through reflex 
action produces a diui-esis independent of the amount 
of water drunk or absorbed. In addition it may cause 
an acceleration of the heart-beat, increased arterial ten- 
sion and greater vigor of the inspiratory act. On the 
intestinal tract it may cause increased peristalsis, and, 
frequently, evacuation of the alvine contents. In other 
cases where relaxation of both the muscular walls of the 
blood vessels of the stomach, or of the stomach 
and intestines, i« great, such as may result from exces- 
sive eating, indulgence in stimulants, or great prostra- 
tion of the nervous system, or from over work or long- 
continued anxiety, normal reaction may be impossible, 
or at least delayed until the water which is taken has 
slowly passed through into the intestines ; when another 
dose may have the desired effect. It may happen that 
the water first taken may produce nausea and vomiting,, 
the stomach being relieved of its abnormal contents. 

The effect of hot water, taken in the morning, also 
varies according to the condition of the alimentary canal 
and constitution of the subject. In the healthy condi- 
tion, previously described, in which the stomach is con- 
tracted to its tubular shape, the vessels are not unduly 
relaxed, and the nervous system is so refreshed by rest 
and sleep that it readily reacts to normal stimulation^ 
the heat may prove to be the reverse of beneficial. If the 
water be simply warm, it will, in all probability, induce 
nausea, while, if hot, the over-stimulation may cause an 
undue secondary reaction, with relaxation of arteries^ 
over-secretion of mucus, and, perhaps, flatulence. This 
secondary relaxation may prevent the intestinal evacua- 
tion, which would relieve the distress. 

However, when there is a pathological relaxation 
and atony of the muscular and nervous apparatus, with 
hypersecretion, distension, and, as a rule, flatulence, the 
hot water may have ju«t the stimulant effect which is 
needed, and give as good results as cold water, or better. 
This is more particularly the case in debilitated condi- 
tions, such as chronic alcoholism. 

Recently I had a case of chronic alcoholism, with gas- 
tric catarrh, cirrhosed liver, and abdominal ascites. The 



308 THERAPEUTIC U8E8 OF WATER, 

patient could not retain anything on his Btomach. At 
last I succeeded in inducing him to drink a glass of hot 
water every half hour, the stomach was relieved, the 
bowels moved freely, the circumference of the abdomen 
was reduced six inches in 48 hours, fermentation of 
stomach was relieved and the patient could take nour- 
ishment. 

The constitutional efifects indirectly induced by the 
drinking of cold (or hot) water are of course those asso- 
ciated with improvement of digestion. 

The constitutional effects directly induced by the 
drinking of cold (or hot) water are slight increase of vas- 
cular pressure, increased flow of urine and at times a lax- 
ative effect upon the bowels, increased secretion of the 
glands of the alimentary canal, and, as a result of thejdis- 
charge of their secretions, the flushing of excretory or- 
gans, particularly of the kidneys, which carry off so 
much of the effete matters resulting from metabolism. 

The therapeutic uses of water wnen given internally, 
either by the mouth or rectum, are partly indicated by 
what I have already said : 

1st. In functional disorders of the stomach and in- 
testines, especially in chronic gastric, or gastro-intesti- 
nal catarrh, and in some cases of constipation in 
flatulent conditions, or catarrhal irritability, causing 
irregularity of the cardiac rythm or palpitation. 

2d. In lithemia, accompanied by acid, high colored, 
urine, the flushing of both the alimentary and urinary 
tracts, with largely increased diuresis, irrespective of 
its increasing the amount of circulating fluid in the 
blood vessels, does actually, as it is popularly expressed, 
purify the blood. 

The application of water upon diseased surfaces and 
in cavities is termed irrigation, because the contact of 
the water with the surface treated is brief and its action 
chiefly local. 

Irrigation of the stomach is called lavage. 

In infants, next to proper regulation of diet and hy- 
giene, is irrigation of the stomach, for by this means you 
remove all food bacteria and fermenting material. 
Thus, it is valuable in all gastro-intestinal troubles of 
children. 

Baruch uses lavage of the stomach for diagnostic pur- 
poses. He says : "When a case of chronic dyspepsia 



A2JDREW McADAMB 8T0VALL. 309 

presents itself, it is my custom to bid the patient eat a 
full meal at 12 :30 p. m. and present himself at 5 :30 for 
exploratory irrigation of the stomach with tepid water. 
The stomach should be thoroughly washed out, even if 
several quarts of water are required, but no larger quan- 
tity than one pint should be introduced at one time. The 
washings should be carefully inspected, when it will be 
readily discovered whether the patient has masti- 
cated his food thoroughly and whether portions 
of food have remained undigested. Thus, a clew 
will be afforded the physician as to the actual 
digestive powers of the patient, and the latter 
attains a valuable guide for future conduct. If the 
washing contains mucus, it is important to distinguish 
between stomach and throat mucus. The former is a 
thick, tenacious, brown mass, which floats upon the sur- 
face of water like the scum on the surface of a pond ; the 
throat mucus is thin, transparent, and quite abundant^ 
being the result of iritation, by the tube, of the pharynx 
and oesophagus. The quantity and quality of the 
stomach mucus indicate with some accuracy the con- 
dition of the gastric mucus membrane. Its rapid or 
slow disappearance, under repeated irrigation and other 
treatment, indicates the character of the disease affect- 
ing the mucous lining ; and the progress of the case under 
such treatment is much more reliable than other treat- 
ment that can be prescribed for these usually hypochon- 
driacal patients. 

In dilatation of the stomach, not due to stricture, but 
simply to gastric atony, the case can be cured, or greatly 
relieved, by irrigation of stomach, five hours after a 
meal, either before breakfast or dinner. 

I know a physician who was in bed for months with 
dilatation of stomach, and several thoroughly competent 
physicians had attended him. Dr. W. H. Johnson vis- 
ited him and suggested washing out the stomach; the 
result was recoverv, or at least sufficient relief for him 
to be up and to do some practice. It is useful in nervous 
dyspepsia, gastralgia and in the fearful pains of gall 
stones. Baruch says that in a case that occurred in hi» 
own family not only was the pain relieved but that the 
gall stones were found in the stools next morning. 

The first case of ileus successfully treated by gastric 
lavage was presented by Kussmaul. The patient was 
admitted in March, 1882. He had been treated bv the 



310 THERAPEUTIC USES OF WATER, 

most approved methods for eight days. The stomach was 
thoroughly washed out, feculent masses were evacuated 
and the irrigation was repeated every three or four hours 
until the water came clear. Then, the patient fell asleep 
for the first time, and on awakening passed a thin yellow 
stool. No further treatment was necessary; recovery 
was complete in five weeks. 

The second occurred a year later. Here again, all 
remedies had been exhausted for nine days without re- • 
suit. Laparotomy was determined upon, but Professor 
Lucke, the surgeon, requested Kussmaull to see the 
patient before operation. One large irrigation of the 
stomach removed immense masses of feculent matter, 
and was followed by sleep, which large doses of morphine 
had failed to secure. 

The publication of these cases aroused so much atten- 
tion that gastric lavage was at once added to the reme- 
dies for ileus. 

In a discussion of Prof. Bordelen's paper on "Ileus" 
at the Berlin Medical Society, Prof. Henock said that in- 
asmuch as an exact diagnosis of ileus is often impossible, 
it is the duty of the medical attendant to resort to gastric 
lavage. He had observed only one case, but the result 
was so remarkable that it made a strong impression upon 
him. He would, therefore, always regard it a great sin 
of omission not to practice lavage in the early stages of 
this malady. 

Dr. CD. Spivak, in The Journal of the American 
Medical Association for April 13th, 1901, in his con- 
clusions of tlio paper entitled ^'Lavage of the Stomach a 
Therapeutic A nent in the Treatment K)f Hal)itual ConMi- 
pation" say^ : "In a preliminary communication I wish 
to call the attention of the profession to the following 
statement. 1st. A certain percentage of individuals 
suffering from habitual constipation are apt to have a 
spontaneous movement of the bowels the following day 
after the stomach has been washed out for the first time. 
2nd. The majority of such patients will eventually re- 
cover the normal functions of the bowels if lavage is con- 
tinued daily for two or three weeks, and, later, at greater 
intervals. 3rd, The best results are obtained by using 
cold water, or hot and cold water alternately. 4th, The 
best time for ??nch lavasre is an hour before breakfast. 



ANDREW McADAMS 8T0VALL. 311 

Enteroclysis is the use of large quantities of water in 
the large intestines by means of a long, rectal tube. It 
is curative in many cases of diarrhoea and dysentery, re- 
moving the materials of decomposition and pathological 
elements. 

By flushing the colon with large quantities of hot wa- 
ter, and using half a pint of hot water and retaining it 
by lying down, you will have a safe and powerful means 
of causing the kidneys to act freely. In entero-colitis, 
by flushing the large intestines you remove all decompos- 
ing material, cause the kidneys to act freely; if cold 
water is used, the temperature is lowered and the child 
that was restless when you commenced goes to sleep for 
one or two hours. To do this in children, place the child 
upon its back, have an assistant elevate the buttocks by 
lifting up the feet, let the colon fill by gravity, then let 
it escape per rectum. 

Cold enemata or irrigations are regarded by Dr. Kemp 
as dangerous in renal diseases, but hot irrigations are 
useful in uraemia and renal insufficiency. 

The external application of water may be classified as 
follows : 

1. Ablution, 2. Half bath, 3. Affusion, 4. The sheet 
bath, 5. The cold bath, 6. The wet pack, 7. The wet com- 
press, 8. Full bath, 9. The douche. 

As it will be impossible for me to describe all of these 
methods and explain them fully I will only attempt to 
describe the full bath or the bath as used by Brand in 
the treatment of typhoid fever. I will describe a bed- 
bath devised by Dr. A. C. Haven, one that can be con- 
structed at a cost of from seventy-five cents to one dol- 
lar. Dr. Haven described it as follows : 

Tie a loop of rope around the head-board, another 
around the foot-board, and connect by two parallel 
ropes; attach the oil cloth with clothes pins, and you 
have as comfortable a bath as the most expensive. The 
loop around the head board and foot board may be dis- 
pensed with in metal beds. Four feet of garden hose 
with a wooden plug in one end makes an excellent 
syphon. 

Technique. The full cold bath is administered as fol- 
lows: The patient receives a stimulant. He is un- 
dressed and a light napkin is applied to cover the sexual 
organs; his face is now bathed with ice- water, and if too 



312 THERAPEUTIC USES OF WATER, 

feeble to step into the bath, the water at 56 degrees, he i» 
lifted in by two assistants, with the greatest gentleness^ 
As he is lowered into the water, he gasps and shudders a 
moment and perhaps cries out. 

But, gentle reassurance by word and deed, quiet de- 
meanor, devoid of haste, and the absence of all actual 
force or argument to resist his natural desire to escape 
from the seemingly heroic treatment rarely fails to quiet 
his apprehensions. Friends or relatives must be advised 
to leave the room, as their presence would increase the 
anxiety of the patient and render him more resisting to 
injudicious and unavailing explanations. If an air 
cushion has been suspended at the head of the tub, it 
will afford a resting place for the patient's head ; a large 
water cushion makes a comfortable rest for the nates. 
In the absence of a support for the head the nurse will 
hold it up with the left hand while with the right gentle 
friction or chafing will be practiced over successive parts 
of the body. This may be done by an assistant, some 
member of the family, or a friend. Care should be taken 
that every part of the body ( except the lower part of the 
abdomen) receives the benefit of these frictions, which 
are regarded as of supreme importance by the origina- 
tor of this method, in preventing chilling, collapse, cy- 
anosis, and heart-failure. The effect of this continuous 
gentle chafing is a suffused redness, which is in marked 
contrast to the previous pallor of the surface, and demon- 
trates that the calibre of the superficial vessels is being 
considerably enlarged. As friction is executed upon 
successive parts of the body, we really manage to main- 
tain a constant contraction and dilatation of the peri- 
pheral vessels, the former being accomplished by the con- 
tact with the cold water in motion, the latter by the fric- 
tion and its attendant reaction. Complaints of chilli- 
ness must not be regarded as an indication for removal 
of the patient from the bath, unless it be accompanied 
by decided chattering of the teeth ; the former is volun- 
tary and may be emotional, the latter is usually involun- 
tary. A small pulse, a cyanotic or shrivelled condition 
of the hands, are regarded by the inexperienced as a 
warning to remove the patient from the bath before he 
has received its full effect. These symptoms may be 
due, it should be remembered, to the local action of the 



ANDREW McADAMS STOVALL. 313, 

cold upon the superficial vessels, and need not be regard- 
ed as threatening, unless the face becomes cyanotic. 
Often the finger nails become cyanotic when the patient 
grasps the edges of the tub in his efforts to hold himself 
while shivering. Pressure against the edge of the tub 
prevents return of the venous blood. All of these signs- 
may be fallacious. Cyanosis of the face, however, is a 
manifestation which demands cessation of the bath. 
Not being submerged, the face can be rendered cyanotic 
only by actual infeeblement of the heart's action, a con- 
dition which is exceedingly rare when the bath is admin- 
istered with friction. That a small pulse is not an indi- 
cation of heart failure will be evident to the reflecting 
observer from the fact that it becomes less rapid and 
compressible, having lost its dicrotic character. 

Before the termination of the tub bath, the patient'a 
bed should be made ready in the following manner : A 
pillow covered by a towel being placed under its upper 
portion, upon the blanket is spread an old linen sheet. 
Several hot water bags or bottles are prepared for the 
feet, which are usually cold after the bath. A bath be- 
ing finished the patient is gently lifted out, the napkin 
covering the sexual organs is rapidly dropped, and he is 
placed upon the previously prepared linen sheets, so that 
the upper edge extends above his shoulders to the nucha. 
Being laid upon the sheet so that his nucha touches the 
upper edge, the sheet is brought around the body. A 
fold being pressed in between the arms and the body, and 
between the lower extremities, with the view of prevent- 
ing appoximation of two body surfaces, the blanket is 
now wrapped around the patient. If the temperature 
has been high, above 103 degrees in the rectum, the 
patient is allowed to lie in a sheet from five to ten 
minutes ; if the temperature is lower, he should be dried 
at once with the sheets and afterwards wrapped in a soft 
blanket. 

In either ease, hot water bottles may be placed to the 
feet. Usually the patient, who has been restless previous 
to the bath, will fall asleep. In some cases shivering 
may continue until reaction ensues. 

Prolonged shivering after a cold bath points to some 
defect, either in duration or temperature. The former 
must be diminished or the latter increased, or both. Dur- 
ing and after the next bath, more attention should be 



312 THERAPEUTIC USES OF WATER, 

feeble to step into the bath, the water at 56 degrees, he i» 
lifted in by two assistants, with the greatest gentleness. 
As he is lowered into the water, he gasps and shudders a 
moment and perhaps cries out. 

But, gentle reassurance by word and deed, quiet de- 
meanor, devoid of haste, and the absence of all actual 
force or argument to resist his natural desire to escape 
from the seemingly heroic treatment rarely fails to quiet 
his apprehensions. Friends or relatives must be advised 
to leave the room, as their presence would increase the 
anxiety of the patient and render him more resisting to 
injudicious and unavailing explanations. If an air 
cushion has been suspended at the head of the tub, it 
will afford a resting place for the patient's head ; a large 
water cushion makes a comfortable rest for the nates. 
In the absence of a support for the head the nurse will 
hold it up with the left hand while with the right gentle 
friction or chafing will be practiced over successive parta 
of the body. This may be done by an assistant, some 
member of the family, or a friend. Care should be taken 
that every part of the body ( except the lower part of the 
abdomen) receives the benefit of these frictions, which 
are regarded as of supreme importance by the origina- 
tor of this method, in preventing chilling, collapse, cy- 
anosis, and heart-failure. The effect of this continuous 
gentle chafing is a suffused redness, which is in marked 
contrast to the previous pallor of the surface, and demon- 
trates that the calibre of the superficial vessels is being 
considerably enlarged. As friction is executed upon 
successive parts of the body, we really manage to main- 
tain a constant contraction and dilatation of the peri- 
pheral vessels, the former being accomplished by the con- 
tact with the cold water in motion, the latter by the fric- 
tion and its attendant reaction. Complaints of chilli- 
ness must not be regarded as an indication for removal 
of the patient from the bath, unless it be accompanied 
by decided chattering of the teeth ; the former is volun- 
tary and may be emotional, the latter is usually involun- 
tary. A small pulse, a cyanotic or shrivelled condition 
of the hands, are regarded by the inexperienced as a 
warning to remove the patient from the bath before he 
has received its full effect. These symptoms may be 
due, it should be remembered, to the local action of the 



ANDREW McADAMS 8T0VALL. 313. 

cold upon the superficial vessels, and need not be regard- 
ed as threatening, unless the face becomes cyanotic. 
Often the finger nails become cyanotic when the patient 
grasps the edges of the tub in his efforts to hold himself 
while shivering. Pressure against the edge of the tub 
prevents return of the venous blood. All of these signs- 
may be fallacious. Cyanosis of the face, however, is a 
manifestation which demands cessation of the bath. 
Not being submerged, the face can be rendered cyanotic 
only by actual infeeblement of the heart's action, a con- 
dition which is exceedingly rare when the bath is admin- 
istered with friction. That a small pulse is not an indi- 
cation of heart failure will be evident to the reflecting 
observer from the fact that it becomes less rapid and 
compressible, having lost its dicrotic character. 

Before the termination of the tub bath, the patient's^ 
bed should be made ready in the following manner : A 
pillow covered by a towel being placed under its upper 
portion, upon the blanket is spread an old linen sheet. 
Several hot water bags or bottles are prepared for the 
feet, which are usually cold after the bath. A bath be- 
ing finished the patient is gently lifted out, the napkin 
covering the sexual organs is rapidly dropped, and he is 
placed upon the previously prepared linen sheets, so that 
the upper edge extends above his shoulders to the nucha. 
Being laid upon the sheet so that his nucha touches the 
upper edge, the sheet is brought around the body. A 
fold being pressed in between the arms and the body, and 
between the lower extremities, with the view of prevent- 
ing appoximation of two body surfaces, the blanket is 
now wrapped around the patient. If the temperature 
has been high, above 103 degrees in the rectum, the 
patient is allowed to lie in a sheet from five to ten 
minutes; if the temperature is lower, he should be dried 
at once with the sheets and afterwards wrapped in a soft 
blanket. 

In either ease, hot water bottles may be placed to the 
feet. Usually the patient, who has been restless previous 
to the bath, will fall asleep. In some cases shivering 
may continue until reaction ensues. 

Prolonged shivering after a cold bath points to some 
defect, either in duration or temperature. The former 
must be diminished or the latter increased, or both. Dur- 
ing and after the next bath, more attention should be 



314 THERAPEUTIC USES OF WATER. 

paid to friction and to ttie administration of stimulants 
in order to further reaction by vis a tergo. The appli- 
cation of heat to the extremities is objectionable, because 
it produces artificial heat internally, and its necessity 
indicates some serious defect in the mode of application 
of the bath if it recurs after several baths. This is the 
ideal bath of Ernest Brand, of Stettin, for the treatment 
of typhoid fever. 

In a discussion of tub bathing in typhoid fever by the 
New York Academy of Medicine, Dr. A. B. Ball said, 
"the reason that the doctors at Bellevue, including him- 
self, had given up the bath treatment some years ago, 
was that they did not employ rubbing; everybody who 
had tried the most recent method, adding friction, had 
been convinced that there was no other method so valu- 
.able." Hare says, "The vaso motor system is made up 
on the one hand of the vaso motor apparatus, and on the 
other of the blood vessels themselves. The resistance of- 
fered to the heart by the properly acting vaso moto sys- 
tem through its influence on the vessels, is identical with 
the friction offered to the driving wheels of a locomotive. 
The locomotive is intended to meet and stand any resist- 
ance, and if the resistance be removed by slippery rails 
the wheels fly around ineffectually, racking the machin- 
ery and destroying its usefulness." 

From the above some important diagnostic and thera- 
peutic facts may be learned : First, that a rapid pulse 
may be due in no way to a disordered heart, but to vaso- 
motor relaxation; second, that the proper way to treat 
this rapid pulse is to put sand on the track and increase 
the resistance and not make more stream or give digi- 
talis which will only cause the engine, or heart, to work 
away on slippery rails with more wear and tear, and 
make no progress . " 

The cold increases this resistance. 

While I have imperfectly presented this subject, I hope 
that such attention has been called to it as to elicit dis- 
cussion. 

I have freely made use of "Hydrotherapy, by Simon 
Baruch." Foster's Practical Therapeutics. Hare's Sys- 
tem of Therapeutics. 



ROBERT SOMMERVILLE HILL. 315 

DLSCUSSION. 

Dr. E. p. Nicholson: I agree entirely with the 
views expressed in the paper as to the value of water in 
the treatment of disease, but when administered inter- 
nally, I wish to call attention to the vital importance of 
knowing that the water is pure and not itself likely to 
cause disease. 

When any doubt w^hatever exists on this point the 
water should be boiled before being administered. 
This would, in my opinion, prevent such diseases as are 
often caused by impurities in water, especially epidemics 
of diarrhoea. 

Dr. I.J. Sellers : Water is essential as a therapeutic 
agent, both to physicians and surgeons, and in many 
cases where drugs fail, it relieves. Uremia, many of the 
diseases of children, typhoid fever, spasms, meningitis, 
and pneumonia, may be mentioned as some of the 
diseases in which baths may accomplish more than drugs. 

After alcoholic debauches, where vomiting is constant, 
no remedy gives more relief than flushing the stomach 
with warm water. 



OVARIAN CYSTS. 



Bt Robert Sommebville Hill. 
Junior Counsellor of the Medical Association of Alabama. 



As this occasion will not admit of a full discussion 
of ovarian cysts I will confine my remarks to that variety 
which mav be termed the true ovarian cvstoma. 

According to Fritsch the proportion of parovarian to 
ovarian cysts is a fraction more than 11 per cent ; Kelly's 
clinic, and Schauta, give 9.1 per cent. Olshausen claims 
that 95 per cent, of all ovarian tumors are cysts and of 
these 3 per cent are dermoids. In the words of Kiwisch 
— "the formation of cvsts in the ovarv is one of the most 
frequent pathological illustrations which are met with." 



316 OYARIAN CYSTS. 

Notwithstanding their frequency and the energy that haff 
been expended in the study of their pathology, no uni- 
versally satisfactory classification has been made, nor 
have their anatomic origin and etiology ceased to be ques- 
tions of dispute. To make clear the views I wish to em- 
brace in this article on the last two questions it is neces- 
sary that I should outline my impression of the forma- 
tion of tumors in general. They are growths produced 
by an activity of embryonic tissue beyond the physiologic 
limitation or requirements of the organism and consist, 
primarily, of cells and a stroma of connective tissue. 
If in the active tumor-forming embryonal tissue there 
is a predominance of the elements of the epi- and hypo- 
blastic cells, there will be developed a tumor of the cellu- 
lar type, whereas, if the elements from the mesoblastic 
cells predominate a connective tissue growth will be pro- 
duced. Observation teaches us that the parts of the or- 
ganism which are formed by the most complicated tissue 
changes in the embryo are most frequently the locations 
of tumorous formations. This fact gives support to 
Cohnheim's claim that active embryonic tissue, produc- 
tive of a tumor, is of congenital origin — having been 
displaced during cell differentiation in the embryo — a 
theory that has more adherents than any other that has 
been advanced to explain the presence of neoplasms. 
Senn maintains that tumor forming embryonic tissue 
may also be of post natal origin. I^athologists are gen- 
erally agreed that no change in tissue structure can take 
place without its cells being first reduced to an em- 
bryonic condition. If this is true, why may not, as is. 
claimed by Senn, a matrix of post natal embryonic tissue 
be formed and, as it were, stored away in the parts to be 
afterwards aroused, by irritation, local or general func- 
tional activity, to supernatural tissue proliferation? It 
is not uncommon to find tumors in areas that have been 
subjected to injuries but which, in many instances, have 
undergone, seemingly, the usual repair. If the tumor is 
developed during the process of repair, the explanation 
could very well be that the injury aroused to activity a 
matrix of embryonic tissue of congenital origin; but 
when the growth is subsequent to a restoration of the 
parts, Senn's theory is, to me, decidedly more acceptable. 
Even in the former case, it seems to me, if the tumor 



ROBERT 80MMERVILLE HILL. 317 

^^correspond to the type of tissue" in which it exists, it 
can with equal, if not more, reasonableness be main- 
tained that some of the cells, which were reduced to an 
embryonic state, for the purpose of repair, were arrested 
before becoming mature tissue and formed the matrix of 
embryonic tissue which produced the tumor. As an 
explanation of the embryonic cells, be they of congenital 
or post natal origin, remaining for a variable period of 
time in a latent state, it has been assumed that their ac- 
tivity is resisted by the general condition of the organ- 
ism, as well as by the local condition of the tissue in 
which they are deposited. The nearer normal the general 
systemic function and the special function of the tissue in 
which the tumor-forming cells are located, the more ef- 
fectual is this inhibitory force. It follows, therefore, 
that any condition which directly or indirectly con- 
tributed to the departure from normal, of the general 
organism or of the local tissue, may be considered a nega- 
tive cause of the embryonic cells undergoing active tissue 
proliferation. I referred above to the general and local 
functional activity acting as excitants to a matrix of 
embrvonic tissue. This claim has been based on the fact 
that tumors, excepting carcinoma, are most frequently 
developed during the period of greatest general or local 
functional activity. I do not, however, believe that this 
is due to normal physiologic activity, but rather to a de- 
parture from it. On the theory that in direct propor- 
tion to the magnitude of a task to be accomplished is the 
liability of the means for its accomplishment to become 
temporarily or permanently deranged, we should expect 
cell vitality to be most frequently disturbed, and conse- 
quently abnormal manifestations during the period of 
greatest functional activity. 

I wish now to call your attention briefly to the de- 
velopment of the ovarv and the process by which the 
ovule is liberated. Within a few weeks after fecunda- 
tion occurs, the ovary is represented in the embryo by a 
group of cells, which subsequently, are separated into 
sub-groups by connective tissue. This tissue is first 
noticed sprouting up from the base of the cells — ^an area 
which represents the medullary portion of the ovary. 
As the separation nears completeness — spaces filled with 
cells being formed — other collections of cells appear on 
the free surface of the connective tissue, to be, in their 



318 OY±RIJLN CT8T8. 

turn, separated after the same manner as were the first. 
Thus the process continues until the seventh month, 
when a single row of columnar epithelial cells, called by 
Waldeyer the germinal epithelium, is formed over the 
greater portion of the surface of the gland. The germi- 
nal epithelium rests on a layer of connective tissue^ 
known as the tunica albuginea. This covering for the 
ovary is not completely formed until the third year and 
is continuous with the stroma and, therefore, can not, 
at any time, be peeled oflf from the substructure. The 
complicated manner in which the ovary is formed is, if 
the theory of Cohnheim is correct, one of the important 
factors in the causation of ovarian tumors ; because, in 
proportion to the complexness in development is, of 
course, the liability to irregularities or imperfections in 
the process. In other words, the development of the 
ovary being so complicated some of the embryonic cells 
are liable to be misplaced during the process and never 
reach maturity. If the embryonic cells, in being dis- 
placed, become entangled in the fibres of the connective 
tissue forming the stroma, this may be the anatomic 
origin of an ovarian tumor. In no other wav can the 
stroma of the ovary be the primary seat of a true cys- 
toma ; because connective tissue can not be transformed 
into epithelium. What is true of the stroma is also true 
of the medullary portion of the ovary. Just here I will 
call your attention to a condition that is not uncommon 
and is apparently due to incompleteness in development, 
I refer to the tubules of Pfluger. These tubules are epi- 
thelial-lined pouches extending into the substance of the 
ovary and opening on its free surface. To me, no more 
plausible theory has been offered in explanation of their 
presence than that the connective tissue stroma stopped 
short of full development, and thereby failed to com- 
pletely surround all of the groups of cells. If this is 
true, is it not probable that some of the uninclosed cells 
shared in the incompleteness and remained embryonic, 
therefore, capable of being stimulated to active tissue 
proliferation? This theory supports the claim that 
ovarian cystoma may have their origin from the tubules 
of Pfluger. 

Turning to the spaces — Graefian follicles — formed by 
the connective tissue stroma and containing cells, we find 
one of the cells much larger than the others. This is 



ROBERT SOMMJERYILLE HILL. 319. 

the ovule. The smaller cells not only surround the 
ovum but thev also line the inner surface of the follicle, 
and by multiplying and disintegrating distend the space 
until its wall and also the tunica albuginea ruptures. 
When this occurs the ovule makes its escape ; hemorrhage 
fills the vacancy with blood and in a few days 
cells bud out from its wall into the blood clot;, 
connective tissue is formed and by contracting 
leaves only a small scar. In* the formation of 
the corpus luteum the cells having become em- 
bryonic for the purpose of producing the necessary tis- 
sue changes, may not some of them fail to reach maturity 
and remain as embryonic tissue capable of being stimu- 
lated to tumorous formation? Here then is a theory 
upon which may be based the claim of the advocates of 
the corpus luteum as the primary seat of ovarian cys- 
toma. 

In a very interesting and valuable contribution by Dr. 
Mary D. Jones the claim is made that inflammation "is 
the beginning and origin of ovarian cystoma." By in- 
flammation I take it Dr. Jones means the result of tissue 
infection by micro-organisms, as this is the only true in- 
flammation. I firmly believe inflammation is an import- 
ant factor in the etiology of these tumors. It may, 
in accordance with the theory of Senn above mentioned, 
be responsible for the presence of a matrix of embryonic 
tissue in the ovary, but I am not prepared to accept the 
sweeping statement that it is the "origin of ovarian cys- 
toma." I also recognize in it a probably frequent excit- 
ant of a pre-formed matrix of embryonic cells to active 
tissue proliferation, but I am constrained to believe that 
there are other conditions that act in the same manner . 
Any tissue that has a function as complicated and ardu* 
ous as that of the ovary is liable to variation in the uni- 
formity of its activity. I am of the opinion that a varia- 
tion in the cell vitality of the ovary, manifested as a 
functional disturbance, is not infrequently responsible 
for existing embryonic cells being aroused to tumorous 
formation. This theory is supported by the clinical ob- 
servation that a greater percentage of nuUiparas than of 
multiparas have these tumors. It is claimed that preg- 
nancy and lactation afford periods of ovarian inactivity. 
If inflammation is "the only condition that can produce 
a cyst of any nature" we should certainly find ovarian 
cystoma proportionately more frequent in the multipara 



520 OVARIAN CT8T8. 

than in the nullipara, because much more ex- 
posed to conditions producing pelvic inflammation. I 
do not question that the walls of every ovarian cyst pres- 
•ent, microscopically, many of the tissue changes common 
to inflammation, short of destruction. If Qriffith is cor- 
rect, these changes may be called regenerative or repro- 
ductive, though no loss of tissue has occurred. He 
claims that "the bulk of the solid parts of all ovarian tu- 
mors is composed of well developed connective tissue 
or of a spindle cell stroma identical with that of the 
normal ovary or of both of these constituents." It ap- 
pears from the foregoing that no part of the ovary is 
exempt from being the primary seat of a cystoma. 

So much for the origin and etiology of ovarian cys- 
toma. I will now briefly review the pathology, as well 
as give some interesting clinical observations. For the 
purpose of facilitating description I will adopt the usual 
classification and consider that there are two kinds of 
cystoma, viz: Papillary and Glandular; though I am 
very much inclined to the view expressed by Thoma that 
"the great frequency with which these combined forms 
of proliferous cysts occur shows that they represent a 
single variety of tumor." Griffith also says, "when it is 
remembered that mixed papillary and proliferating 
(glandular) cysts are by no means rare it appears most 
probable that they arise from the same structures." 
Primarily, they both are composed of cells and connec- 
tive tissue. In the papillomata the connective tissue is 
in excess and is "lined by a single layer of columnar 
cells," often ciliated," except at points where new papil- 
lae are being formed when the layers are multiple" 
(Griffith). Rarely are papillary growths found on the 
surface of the ovary without microscopical evidence of 
a pre-existing cyst. The possibility of their developing, 
de novo, from the surface is denied by many. It is main- 
tained that when they so appear the papillge ruptured 
the cyst early and by continued growth destroyed the 
evidence of its existence. In opposition to this theory 
TJflfenheimer claims that the investigations at the Berlin 
Pathological Institute prove that the surface epithelium 
of the ovary proliferates and penetrates into the sub- 
stance of the gland, forming pouches from which the 
papillomata cyst develops. Papillae are found on the 



ROBERT aOMMBRVILLB HILL. 32I 

outer surface of 33 per cent of cystic papillomata. When 
the peritoneal cavity is invaded papillae are detached 
from the parent growth and distributed over the peri- 
toneum, forming new foci and causing the rapid develop- 
ment of ascites, ss well as many adhesions. The growth 
of a papillary tumor, as a rule, is slow. It rarely attains 
a size larger than a cocoanut. About 50 per cent, are 
bilateral. Some claim that they have their origin from 
the medullary portion of the ovary and frequently de- 
velop downward between the folds of the broad ligament. 
It has never been proven that a papillomata can become 
a carcinoma, though the two diseases have, not infre- 
quently, been found in the same patient. 

Case 1. Through the courtesy of Dr. R. P. Michel of 
Montgomery, I saw, not a great while since, a patient 
with a papillary ovarian cyst, the course of which illus- 
trates the necessity of early operation. She was a mul- 
tipara, 43 years old. Previous history good. A tumor, 
the size of a quart cup, of the right ovary was diagnosed 
and she was advised to have it removed, but said she 
would consider the operation after returning from a 
visit of a couple of months she expected to make. While 
absent, her abdomen began to enlarge very rapidly and 
when she returned it was enormously distended with 
fluid. On opening the abdomen I found practically the 
entire peritoneal surface covered with papillae. The 
lowest portion of the abdominal cavity was choked with 
papillary masses. No further effort was made to re- 
move the tumor, as the free hemorrhage that would have 
been produced would have terminated her life on the 
operating table. Supposing it had been possible to re- 
move it, I do not think any good would have been accom- 
plished by doing so, as the peritoneum was so extensively 
involved. It is seemingly true that the removal of the 
parent growi:h checks the disease, if the peritoneum is 
not too extensively involved. In fact, some gynecolo- 
gists claim that they have been encouraged to undertake 
a second operation, not only on account of the disease 
being checked, but rendered less severe as a 
result of a former effort, in which they were 
not able to remove the tumor. The case re- 
ported survived a number of months after leav- 
ing the Hill Infirmary. I am of the opinion the perito- 
neum was so slightly, if at all, involved at the time of the 

21 



322 OYAItlAN OYSTB. 

first examination that if she had then accepted the opera- 
tion she would have made a good recovery. 

We will now turn our attention to the most frequent 
of ovarian tumors, viz: Glandular Cystomata. It is 
ten times more common than the papillary cyst. Kelley 
has found both ovaries involved in 6 per cent of his cases. 
It is usually multilocular or gives evidence of having 
been. As a rule, it grows very rapidly and in the absence 
of interference reaches an enormous size. Unlike the 
papillary, its cells are in excess of its connective tissue 
and are polymorphous, though the columnar predomi- 
nate. The first stage of its development is a group of 
proliferating cells. As the mass increases the cells in 
its center undergo a degenerative process, forming fiuid. 
Thus the primary cyst is begun. At first the wall con- 
sists of a comparatively loose connective tissue which is 
soon reinforced by a dense, firm, structure, formerly the 
covering for the ovary. The wall, therefore, of the pri- 
mary cyst may be said to consist of tw^o layers of con- 
nective tissue and to develop pari-passu with the cell 
changes in the cavity. The cells lining the inner sur- 
face of the cyst are stratified. 

At some points the columnar cells proliferate more 
rapidly than at others, causing a cellular nodule which 
is supported by connective tissue derived from the inner 
layer of the Avail. This tissue by encompassing a vari- 
able number of the proliferating cells completes the 
loculi forasecondary cyst. But, as the Thrall of the second- 
ary cyst is not strong, it often ruptures, forming a com- 
munication with the parent cyst. A continuation of this 
process is the cause of the, not uncommon, honeycombed 
appearance of glandular cystomata. As the wall of the 
cyst contains its blood vessels, their rupture often causes 
hemorrhage which discolors the cystic fiuid. It has been 
claimed that the cells of a glandular cystomata may 
loose their proliferating power and entirely disappear, 
in which case the growth of the tumor would cease. I 
think this is very doubtful, and, if true, is of such rare oc- 
currence as to be of no practical importance. Ordinarily 
the fiuid which these tumors contain is not infectious, 
therefore, general peritonitis does not usually follow its 
escape into the abdominal cavity. Garrigues claims 
that in 8 or 10 per cent of all operations for ovarian cysts 
evidences of rupture can be found. Glandular cysto- 



ROBERT 80MMERVILLE HILL. 323 

mata usually grow upward and are attached to the 
uterus by pedicles, which vary much in size and length. 
Twisting of the pedicle, by rotation of the tumor, some- 
times occurs ; if it is sudden and sufficient to cut off the 
blood circulation the tumor will become gangrenous, 
but if the twisting is gradual adhesions may form, 
through which nourishment will be supplied, enabling 
the tumor to live and grow, though it becomes entirely 
separated from its original attachment. Dr. J. Knows- 
ley Thornton found the latter true in four cases out of 
600 ovariotomies. (A. J. M. S. Oct. 1888). These tu- 
mors often become carcinomatous, though they may, 
from a practical view point, always be regarded as malig- 
nant, because, uninterfered with, their course is towards 
destruction of life. 

I must not longer tax your patience by yielding to my 
inclination to enter into a clinical review of this subject. 
However, I hope by presenting ten very large multilocu- 
lar ovarian cysts, removed during the last year or so 
from as many patients, to draw out a full clinical dis- 
cussion. 

By considering the folds in these sacs you may get an 
idea of the size of each tumor. The smallest was be- 
tween two and three gallons in size. Of these ten cases 
one was unfortunate in its termination — dying on the 
fourth day following the operation. Time will not ad- 
mit of my giving the history of each case but the speci- 
men marked, number six, came from a patient whose his- 
tory ilustrates so forcibly the possibilities of the art of 
surgery that I am constrained to briefly review it. 

She was referred to me by my friend. Dr. Wilkinson of 
Prattville, Alabama. White, multipara, about fifty 
years old, with a good family history. Emaciation was 
extreme, pulse was rapid and thready. The distension 
was so great that she could not lie down, and caused her 
respiration to be shallow and hurried. After nourish- 
ing and stimulating her for several weeks I had the 
anaesthetizer to undertake to etherize her for the opera- 
tion. Under its influence she became very much cya- 
nosed and her pulse and respiration were so bad that 
the ether had to be discontinued. It occurred to me that 
there was fluid outside of the tumor, the removal of 
which would give her more breathing space. Acting on 



^.— m 



**<':%;/^'^J. |{<^ '.•*^'h>.z x4.* *l:z*".t!T inp»r»»T*^L I final It 
h>.f\ 'r^-T 7^:jf^''\^\r0-i\ ^''h ^hlrr^-f-rsi ai>i *^»j:«??:^i the 
;i:vJ^r',^f, Afr^^ firax^i^ rh^ fliSi fr^.m the ej^st.* and 
W'^,'9ir^\x\t u pixij a^Jr.<^ion« I found th^ I^wer p»»rrion of 
f ? ^ f-irt.or to ^1^ a •^^Id majMi w*^:r^i and firmiT ailherent 
in f K*' [^-'rl/' /';iv'rr, TTiIif ma.^ »aji with zreat d:ffi«-altT 
fU'^Hf'\»M\ 3n#| /J<'li v^T*^!, In hf*^k:nz UrjeJe the ailhf^ions 
tf*'^%t'f^$ fh^ fi^A'A muf^ awl the f«elric wall in front I 
o\f^^ti't\ a rffvUr rirmtain?n;r «ereral onne«? of pes. The 
fff^rifouf'^l ^'Si'/ity wan well and fr»^penrlT fleshed with 
hof n'llf. %'7\U'r during 'li** j«^'j>aratIon and dHiverr of the 
f ttfuoK The #f^>zinjf, whir-h tia.s qnite free, was eimtrolled 
hy fm-^^rire from a Mikfilir-z'H drain^ A larjre qoantitr 
of nuU n^plniion w?i« left in the aMomen. The patient 
w;iK ret limed to Ik-^I, the frn^t of whieh wa« elevated. She 
n^strUul qiiir'kly and well. Her re<-overT was nninter- 
ru)fU*il, You will oliwrve that the solid and cystic por- 
lUfun of tlim tumor are separate. In other words, the 
ryntU' fiortlon Is nrrt a dej^eneration of a solid mass, but 
\h a typi^'al miiltilrKrnlar ovarian cyst. My opinion is 
itiiit the eystic and mUd portions of the tumor had 
Nepariifi' lociill of development. 



REPORT OF CASES. 



Br Jamba Adrian Goooans. 
Ornnd H4*ntor (UmnnoWor of the Medical Association of Alabama. 



Wllliln llio i)aHf four months the cases to be reported, 
II nd from wlilcli the specimens that will be exhibited 
\v(»n» r(Miiove<l, luivc> boon operated upon by Dr. W H. 
IIihIhou, of liH Fayette, and myself, in conjunction. 

(^040 I. Females aged 40 years, married, has had five 
chlhlren. Not IccmI that she had pelvic trouble about one 
yiHW ap>. Hhe was first seen by us on March 9th, 1901. 
ller temperature at that time was 99 degrees, pulse 90, 



JAMEB ADRIAN OOGGANB. • 825 

Physical examination revealed a more or less fixed tumor 
in the region of each ovary. Any attempt to move or 
elevate the uterus caused considerable pain. During 
the week she developed high temperature and the evi- 
dences of pelvic pertonitis. On the 19th of March, the 
day of the operation, her temperature was 103 and pulse 
120. A point of special interest in the case was the dif- 
ficulty encountered in making a differential diagnosis, 
as to whether an infiammatory condition was present or 
possibly an abscess or a cancerous disease of the append^ 
ages, with an acute pelvic peritonitis resulting there- 
from. We were inclined to believe that the latter condi- 
tion existed. Ad immediate operation was advised and 
accepted, which required an abdominal incision, about 
5 inches in length. 

I here show you the specimens which were removed. 
You will observe that they are polycystic in development, 
mixed with more or less solid tissue. The uterine attach- 
ments of the broad ligaments were somewhat thickened, 
but not so invaded by the disease as to prevent the liga- 
tures from being placed in firm tissue, thus completely 
controlling the hemorrhage. 

The abdominal peritoneum lying immediately over the 
right ovarian tumor was intensely congested. There were 
many adhesions, but the tumors were totally removed. 
A small cancerous mass had developed in the omentum, 
which was ligated and excised. 

A tumor which was encroaching upon the intestine 
was also developing in the mesentery. One of the largest 
of these cysts was ruptured while making the enuclea- 
tion and its fluid contents were emptied into the pelvic 
cavity and over the walls of the abdominal incision. 
After the removal of the tumors the abdomen was irri- 
gated with hot normal salt solution and the incision 
closed by through and through silk- worm-gut sutures . 
The patient made a good recovery and left the hospital 
within three weeks. 

Case 2. Miss A., aged 42 years. About 7 years ago 
menstruation became more profuse than usual and on 
this account she consulted a physician who discovered 
in the i)elvis a small, centrally located, tumor, and a 
laterally located tumor of about the same size. 

At this time they were pronounced myomata. Her 
health remained good, although, recently, on account of 



324 REPORT OF OABBS, 

this supposition, after allowing her to rest a few days, 
I made an opening, under cocaine anaesthesia, three 
inches below the ensiform cartilage, into the peritoneal 
cavity, through which about one quart of ascitic fluid 
escai>ed. Her breathing was slightly improved. I finally 
had her anaesthetized with chloroform and opened the 
abdomen. After drawing the fluid from the cysts and 
separating many adhesions I found the lower portion of 
the tumor to be a solid mass wedged and flrmly adherent 
in the pelvic cavity. This mass was with great difficulty 
detached and delivered. In breaking loose the adhesions 
•between the solid mass and the pel vie wall in front I 
opened a cavity containing several ounces of pus. The 
peritoneal cavity was well and frequently flushed with 
hot salt water during the separation and delivery of the 
tumor. The oozing, which was quite free, was controlled 
by pressure from a Mikulicz's drain. A large quantity 
of salt solution was left in the abdomen. The patient 
was returned to bed, the foot of which was elevated. She 
reacted quickly and well. Her recovery was uninter- 
rupted. Ycm will observe that the solid and cystic por- 
tions of this tumor are separate. In other words, the 
cystic portion is not a degeneration of a solid mass, but 
is a typical multilocular ovarian cyst. My opinion is 
that the cystic and solid portions of the tumor had 
separate loculi of development. 



REPORT OF CASES. 



Bt James Adrian Goggans. 
Grand Senior Counsellor of the Medical Association of Alabama. 



Within the past four months the cases to be reported, 
and from which the specimens that i;iill be exhibited 
were removed, have been operated upon by Dr. W H. 
Hudson, of LaFayette, and myself, in conjunction. 

Case 1. Female, aged 40 years, married, has had five 
children. Noticed that she had pelvic trouble about one 
year ago. She was first seen by us on March 9th, 1901. 
Her temperature at that time was 99 degrees, pulse 90. 



JAME8 ADRIAN OOGGANB. • 826 

Physical examination revealed a more or less fixed tumor 
in the region of each ovary. Any attempt to move or 
elevate the uterus caused considerable pain. During 
the week she developed high temperature and the evi- 
dences of pelvic pertonitis. On the 19th of March, the 
day of the operation, her temperature was 103 and pulse 
120. A point of special interest in the case was the dif- 
ficulty encountered in making a differential diagnosis, 
as to whether an inflammatory condition was present or 
possibly an abscess or a cancerous disease of the appends 
ages, with an acute pelvic peritonitis resulting there- 
from. We were inclined to believe that the latter condi- 
tion existed. Ail immediate operation was advised and 
accepted, which required an abdominal incision, about 
5 inches in length. 

I here show you the specimens which were removed. 
You will observe that they are polycystic in development, 
mixed with more or less solid tissue. The uterine attach- 
ments of the broad ligaments were somewhat thickened, 
but not so invaded by the disease as to prevent the liga- 
tures from being placed in firm tissue, thus completely 
controlling the hemorrhage. 

The abdominal peritoneum lying immediately over the 
right ovarian tumor was intensely congested. There were 
many adhesions, but the tumors were totally removed. 
A small cancerous mass had developed in the omentum, 
which was ligated and excised. 

A tumor which was encroaching upon the intestine 
was also developing in the mesentery. One of the largest 
of these cysts was ruptured while making the enuclea- 
tion and its fluid contents were emptied into the pelvic 
cavity and over the walls of the abdominal incision. 
After the removal of the tumors the abdomen was irri- 
gated with hot normal salt solution and the incision 
closed by through and through silk- worm-gut sutures. 
The patient made a good recovery and left the hospital 
within three weeks. 

Case 2. Miss A., aged 42 years. About 7 years ago 
menstruation became more profuse than usual and on 
this account she consulted a physician who discovered 
in the pelvis a small, centrally located, tumor, and a 
laterally located tumor of about the same size. 

At this time they were pronounced myomata. Her 
health remained good^ although, recently, on account of 



^26 * ttEPORT OF OASlEB. 

the persistence of uterine hemorrhage and the increased 
growi;h of the tumors, she had become ansemic. She re- 
quested an operation, which was performed. I here 
show you the mass that was removed. The abdominal 
incision was about 8 inches in length. You will observe 
the centrally located fibroid occupying the fundus of the 
uterus and the left lateral fibroid extending well out 
into the broad ligament and to the pelvic brim. The 
operation was pan-hysterectomy, followed by suture of 
the peritoneum, closing the pelvic outlet. The patient 
made a complete recovery. 

Case 3. Miss B., aged 42 years. Ten years ago, on 
account of irregular and profuse menstruation, she con- 
sulted a physician, who informed her that she had a cen- 
trally located tumor in the pelvis. About one year ago 
she suffered from severe pains in the pelvis. Suddenly, 
something came down into the vagina and the intensity 
of the pain diminished. We saw this patient in Janu- 
ary, 1900. She was very weak and anaemic, hasmaglobin 
being only 30 per cent. The physical examination re- 
vealed the presence of this large centrally located tumor, 
which I show you, and with this mass hanging in the 
vagina, — ^a myoma with a polypoid projection into the 
vagina. Under rest, massage, iron, and forced nutrition 
for tw^o weeks hsemaglobin increased to 40 per cent., but 
she was still in bad condition for an operation. The 
abdominal incision in this case was eight inches long, 
and the operation was pan-Hysterectomy. The vagina 
was cut, as you will perceive, from its uterine attach- 
ment after the uterine arteries had been ligated through 
the abdominal incision. You will observe, also, that had 
the operation of supravaginal hysterectomy been per- 
formed in this case a tumor almost as large as a foetal 
head would have been left hanging in the vagina. By 
vaginal examination it was impossible to reach the cer- 
vix with the finger, and after the vagina had been sepa- 
rated from the tumor considerable force was exerted to 
lift the tumor, with this bulbous polypoid projection, 
from the pelvis. The abdominal incision was closed by 
sutures, each layer separately. The patient made a 
good recovery. 

Case 4. Mrs. J. C, aged 33 years. Diagnosis of 
uterine myoma made, advised operation, to which patient 



DI8CUBSI0N. 327 

submitted. On opening the abdomen multiple fibroids 
were found, the largest one, which I here show, being 
attached to the fundus of the uterus by a small pedicle, 
about one inch in diameter. During the preliminary 
examination this pedicle was torn and some hemorrhage 
resulted therefrom. 

Numerous other myomata were found, necessitating 
pan-hysterectomy. Nothing resembling tubes, ovaries, 
or broad ligaments was ever seen, all being bound down 
very closely to the pelvic floor. But for the necessity 
of a rubber ligature a bisection of the uterus would have 
simplified the operation. As it was, the operation was 
finished per vaginam. This patient made a tedious re- 
covery. 

Case 5. Mrs. L. J., aged 44 years, had one child 26 
years ago. About 15 years ago she noticed a small tumor 
in the right side which grew slowly but gradually until it 
filled the abdominal cavity. A severe attack of inflam- 
mation of the veins of the leg brought about the decision 
to have the tumor removed. The specimen, you will ob- 
serve, is of interest as a ligamentous cyst. It was de- 
cided to remove this tumor by making an approach from 
the free side and doing a hysterectomy. The specimen 
shows that it could have been removed otherwise, but it 
was perhaps easiest, after the uterus had been removed, 
to close the great cavity it occupied by sewing the peri- 
toneal surfaces together. 

This patient made a good recovery. 

DISCUSSION. 

Dr. E. A. Jones : I want to express my thanks for the 
most excellent paper by Dr. Hill. I think a paper of 
this nature necessarily suffers because it cannot be ap- 
preciated with such rapid reading. When printed we 
can enjoy it much more. I have been, within the last 
year, especially interested in the subject of "Ovarian 
Cysts." At Dr. Davis' Infirmary there is a specimen of 
a composite teratoma of the ovai'y. A diagnosis of a nor- 
mally developed embryo, with a ruptured ectopic 
gestation into the sack of the pre-existing ovarian cyst, 
had been made by the Gynecologist. In the considera- 
tion of the etiology of ovarian neoplasm Cohnheim's 
theory is very useful and as the doctor has said server 



328 JAME8 ADRIAN OOOGANB. 

to explain many otherwise obscure phenomena. It is 
highly probable that in many of these conditions follow- 
ing inflammation, frequently, the embryonic cells under- 
go malignant transformation. Dermoid cysts are prob- 
ably best explained by the theory that there is an infold- 
ing and subsequent pinching-off of the skin (either whole 
skin or simply epidermis), subsequently undergoing cys- 
tic development. Teratomata, especially the composite 
variety, probably are the result of a fcetal inclusion.^' 

Dr. Copeland : There is only one question which I care 
to refer to and that is the control of the hemorrhage. 
Of course the abdominal operations are very successful. 
The easiest way to control a hemorrhage is with an an- 
giotribe, with pressure of 2800 to 3200 pounds. This is 
left on the patient two minutes and the parts divided. 
When this is removed the other side is treated in the 
same manner. If the angiotribe is left on a few minutes 
you have no more hemorrhage. 

Dr. Harper, of Selma : I want to ask one question . 
There are three methods of controlling hemorrhage, 
with the angiotribe, silk, and catgut. I should like the 
question discussed as to which is the preferable method. 

Dr. Copeland : I prefer the angiotribe. The instru- 
ment is devised for the purpose of excluding the ligature 
entirely. After the instrument is adjusted and left in 
position for three minutes there is no danger of hemor- 
rhage. Then cut close to the instument. 

Dr. F. G. Dubose: T^he angiotribe is used exten- 
sively by the Berlin surgeons. It was my pleasure to 
see it used there. It is not suited for hemostasis in ex- 
tensive operations, those for large fibroids, and where 
many adhesions and much vascularity complicates the 
operation. In London the surgeons prefer silk as a liga- 
ture. Cat gut is all right, can be perfectly sterilized, and, 
can be procured in a perfectly aseptic form from many 
reliable dealers in this country. It is not so absorbable, 
however, as is frequently claimed. I have removed the 
plain cat-gut from a wound three weeks, and chromicized 
cat-gut six weeks, after introduction. 



\ 



DISCUSSION. 329 

Dr. L. C. Morris : I have never had any personal ex- 
perience with the angieotribe, but I had the pleasure of 
seeing Dr. Cleveland of the Womans Hospital of New 
York use it to stop a hemorrhage. He put it on with a 
pressure of 3000 pounds and kept it on two minutes, and 
afterwards remarked that he felt absolutely safe against 
hemorrhage. Cat gut can be absolutely sterilized. Dr. 
Hunter of Johns Hopkins perfected cat gut which will 
stay from 20 to 30 days. There is no danger of infec- 
tion if cumolized cat gut is used. 

Dr. B. S. Hill (closing) : I wish to thank Dr. Jones 
for his kind remarks, which I appreciate the more be- 
cause I know that he is devoting his time largely to the 
study of pathology, and feel that it is a compliment to 
any of us to have him favorably criticise our work. 

In regard to Dr. Copeland's sujggestion, I do not think 
that instrument can be expeditiously applied in the re- 
moval of large tumors, such as I have shown you. In- 
deed, it is impossible to remove tumors fixed in their 
position by many adhesions without using ligatures to 
control the hemorrhage. Now, as for the best material 
for ligatures, I do not think we are prepared to entirely 
give up silk, though I use cat-gut a great deal more than 
I did a few years ago. For a long time I experienced 
great difficulty in preparing my cat-gut, but since I have 
been using the formaldehyde method this has not been 
the case, and my results have been more satisfactory. I 
do not have the suppuration I formerly had. I take the 
plain cat-gut and roll it, one layer thick, on glass tubes 
or reels and tie it, to prevent it from getting loose or un- 
rolling. The tubes are put into a solution of formalde- 
hyde, one part to twelve of water, and allowed to remain 
for twenty-four hours, after which they can be boiled 
with the instruments for fifteen minutes without impair- 
ing the strength of the gut. 



330 REFLEX NEUROSES IN WOMEN. 



REFLEX NEUROSES IN WOMEN. 



Br Edward Bubton Wabd. 
Junior Counsellor of the Medical Aasociation of Alabama. 



No other class of patients tax the forbearance and 
skill of a doctor more than those cases of transferred 
nervous troubles daily presented to us either at 
the bedside or in our offices. I might also add that there 
are no cases with which one can establish a reputation 
more easily. Coming to us as they do, day after day, re- 
hearsing the some monotonous tales of vagrant and in- 
definite pains, we are apt to become indifferent and to 
overlook the real cause of the trouble. This is a mis- 
take ! We should make it the rule to go into a careful 
examination of every case, note each symptom, search 
out tlie cause and discover what distant organ is diseased 
and may be transmitting these perplexing phenomena. 
There is a cause for every deviation from the normal, and 
every pain or paroxysm is but the signal telegraphed 
from the offending organ. Truly has it been said that 
"many of these simple deviations from the normal are 
really precursors of conditions of a most serious nature. 
There is every reason to investigate carefully these minor 
ailments, because of their frequency and the important 
bearing they have upon our success as practitioners." A 
glance at the wonderful mechanism of the nervous sys- 
tem is sufficient to explain why we are made to suffer 
pain. Connected by a more perfect system of rapid 
transit than the mind of man ever conceived, with the 
battery cells of the cerebro-spinal system to furnish the 
motive power and the multitudinous nerve fibres spread- 
ing over the entire body, transmitting the current, we 
are prepared to give notice when any point along this 
circuit is not working smoothly and in order. 

"Man's greatness is shown after a lamentable fashion, 
by the endless variety of aches and pains by which he 
is teased or tormented, and by the lifelong power of en- 
during their fiercest assaults. Besides pain, man is 



SDWARD BURTON WARD. 33I 

vexed by an army of strange sensations, overwhelming 
emotions, and vexatious thoughts. Nevertheless, pain 
often serves a useful purpose, for, as a rule, it insures the 
cure of a host of diseases, which would otherwise only 
become known when incurable." 

It is not my purpose to go into a study of the minute 
or gross anatomy of the nervous system in the presenta- 
tion of this paper; time would not permit such 
details, nor would I tax your patience with 
them. The study of the nervous system is too pro- 
found, and the history of the numerous reflex centres 
now known is too long for a reproduction here. Still, 
we can not fully understand these perplexing reflex 
troubles until the anatomical relations and physiologi- 
cal functions of the various nerve tracts have been 
^^raced from the terminal plates to the central ganglia." 
These groups of symptoms — ^most of the reflex neuroses 
being symptoms, yet often producing more distress than 
the organic disease from which they take their origin, 
"emanating from an obscure, localized irritation, affect- 
ing important organs most diverse in their functions, 
connecting distant parts by a chain of ganglionic and 
cerebro-spinal nerves, involving the system in all its 
parts, form subjects of interest and study, not alone for 
the specialist and gynecologist, but for the general prac- 
titioner, also. The brain acts as a central reflex organ, 
but the spinal cord is the central reflex organ par excel- 
lence, not so much from the great number of reflex cen- 
tres located in it, as from the fact that this is probably 
its most important function; while the brain, including 
the medulla, is much devoted to other important func- 
tions. The gray substance of the cord is the principal 
central reflex organ within which the exchange from af- 
ferent to efferent impulses is ett'ected. Then the sympa- 
thetic or ganglionic system comes in for its share of at- 
tention, with its special ganglia, the solar plexus, most 
intimately concerned in the gastric neuroses." A neu- 
rosis may then be defined as a generic term for condi- 
tions of hypersBsthesia or disturbance of the nervous sys- 
tem which set up disease in an organ that is healthy, 
or without evident lesion of any of its parts. These dis- 
orders are marked by total intermissions, which are 
never found in true organic disease, although the latter 
may have great remissions. Functional diseases are al- 



832 REFLEX NEUROSES IN WOMEN. 

ways peripheral, never central, although the centres may 
be atfected secondarily. Dalton says, the irritability of 
the sensitive nerve fibres is most directly manifested dur- 
ing life by the production of sensation. This sensation, 
however, does not exist in the nerve itself, but in the ner- 
vous centre where its fibres terminate. The nervous sys- 
tem stands as a medium of communication between dif- 
ferent parts of the living body, so that a stimulus applied 
to one organ may excite the activity of another. This 
communication between adjacent or distant parts is 
never direct, but always a circuitous one. It passes in- 
variably through an intermediate nervous centre, w^hich 
receives the impression conveyed to it by nerve fibres 
from one organ and reacts by sending out a stimulus 
which calls into activity the other. This is called the 
"reflex action" of the nervous system, because the stimu- 
lus is first sent inward to the nervous centre and then re- 
turned or reflected in the opposite direction. In this 
process, the intermediate act between the inward and 
the outward passage of the nervous stimulus is accom- 
plished in the gray substance of the nervous centres. 
Each organ or anatomical element, when subjected to the 
application of a stimulus adapted to its physiological 
character, reacts in a way peculiar to itself and produces 
a visible result of a definite kind. The sympathetic ner- 
vous system undoubtedly serves as a medium of refiex ac- 
tion between the sensitive and motor portions of the di- 
gestive, excretory, and generative apparatus; and it is 
certain that it takes a part in which the cerebro-spinal 
system is also interested. There are accordingly three 
different kinds of refiex action which may occur wholly 
or partially through the sympathetic system. 

1. Reflex actions taking jplace from the internal or- 
gans, through the sympathetic and the cerebro-spinal 

' system, to the voluntary muscles and sensitive surfaces. 

2. Reflex actions taking place from the sensitive sur- 
faces, through the cerebro-spinal and sympathetic sys- 
tems, to the involuntary muscles and secreting organs. 

3. Reflex actions taking place through the sympa- 
thetic, from one part of the internal organs to another. 

McGillicuddy says that "the stomach and intestines 
are probably the most frequent cause of transferred 
pains;" after these he places the uterus and its appen- 
dages, and ne3rt the eye or heart Irritation from the 



EDWARD BURTON WARD. 333 

stomach causes reflexly a large variety of pains. "It is 
not possible to decide always whether these pains are re- 
flex, or are due to vaso-motor disturbances, or the circu- 
lation of morbid products in the blood, as in cases of fer- 
mentative dyspepsia." Another authority divides the 
reflex-neuroses into : 1. Those of the pelvis ; 2. Those of 
the alimentary canal ; 3. Those of the head ; 4. General 
nervousness, including hysteria. 

When the Great Anatomist carved with His scalpel 
an image out of atomic nature and called it, Man, the 
grandest result was thought to have been attained. 
When from Man, throbbing with life, a portion of his 
anatomy was extracted to make for him a com- 
panion, then the acme of perfection was truly 
attained. Well could He rest from His labors, 
for the master piece had been produced. Defying 
imitation, this result of Divine skill stands preeminent, 
without a parallel in the world. The hand of a Phidias 
fashioned out of marble a vain effort to imitate; the 
brush of a Raphael or a Michael Angelo took up the 
task, but to fail. "This mysterious problem can never 
be thoroughly understood. Scince, with profane hand, 
seemed almost to raise a corner of the veil which hides 
the secret of the creative energy, when the microscope 
revealed to the curious gaze the primordial embryonic 
atom, almost at its first conception. The first impulse 
of a new existence, about to repeat that ever wonderful 
miracle, the incarnation of spirit, seemed almost pre- 
sented to the eye. But here human intelligence pauses. 
The voice of God says again, as of old it said to the en- 
croaching waves: "Hitherto shalt thou come, but no 
further." Whatever may be the essence of life, be it 
agent or endowment, it is only known by its phenomena. 
The lily has yielded its softest tints to this marvellous 
creature. There was placed in the citadel of thought 
the great batteries of the brain which fiash from her face 
the expressions of every emotion and reflect the image of 
her maker. Thought and reason predominate. Along 
the insulated conductor is laid the great cable, the spinal 
cord, from which pass out the many electric wires, es- 
tablishing a perfect system of communication, along 
which are transmitted the currents of life. How strange 
that such a perfect being should be permitted to suffer 



334 REFLEX NEUROSSa IN WOMEN. 

pain, and how hard to realize, as we see her with haughty 
mien and graceful step, the poetry of motion and the 
evolvement of beauty, permitted to toss in the throes of 
hystero-epilepsy, or become inanimate in the grasp of a 
cataleptic spell. 

Why then, this decree of an all wise Maker? 

"Of mans' first disobedience and the fruit 
Of that forbidden tree, whose mortal taste 
Brought death into the world and all our woe." 

The Divine injunction : "Be fruitful and multiply," is 
often followed with a penalty, and the perpetuity of our 
race results in pain and diseases. Yet, still — 

"Our Maker bids increase; who bids abstain 
But our destroyer, foe to God and man?" 

The delicate structure of the sexual organs in women, 
and the Herculean task imposed upon them renders 
women prone to reflex nervous troubles. The uterus and 
its appendages from the continued performance of their 
functions, sooner or later take on inflammatory symp- 
toms which are reflected to other and more remote parts 
of the body. We have, says a writer, come to feel that a 
woman's organs of generation are seldom in a state of 
perfect health ; rather more, that they are centers from 
which emanate the most terrible and awful nervous ex- 
plosions. Every vibration of the nerve-fluid in the geni- 
tal terminals meets with a sympathetic reverberation, 
and is often re-echoed a hundred fold in the spinal and 
cerebral centers, which reflect even the physiological ac- 
tion of the reproductive organs. 

In the highly sensitive nervous organization, then, of 
woman, we find these reflex symptoms most frequent 
and intense, and they are most fully developed in re- 
sponse to lesions of the sexual organs, the controlling in- 
fluence in the functional life of woman . Says Engle- 
man : "The uterine organs respond readily to a cerebral 
impulse by the intertwining of the ganglionic and cere- 
bro-spinal system." The most important reflex neu- 
roses come under the classification of the Hystero- 
Neuroses. 

Engleraan's definition of the hystero-neuroses is: 
"Phenomena which simulate a morbid condition in an 



EDWARD BURTON WARD. 335 

organ which is in an anatomically healthy state and 
which are not due to structural changes in the organ in 
which they appear, but to morbid or physiological 
changes in the uterus and ovaries." Engleman has writ- 
ten a very valuable article on this subject. He states 
that in the vast majority of these cases the trouble is 
dependent upon uterine changes alone, and not upon 
those of the ovary. "Treatment directed to the uterus 
proved more successful." This statement is verified by the 
frequent failure to cure these attendant nervous symp- 
toms after the simple removal of the ovaries and tubes. 
We should never, therefore, guarantee to our patients 
a perfect cure of their nervousness after such opera- 
tions. "Whatever result is obtained in amelioration of 
these symptoms is dependent indirectly upon the uterine 
involution following, and not directly by the removal of 
the ovary as the offending organ." Most of the neuroses 
come on near, or accompany, the menstrual period. "The 
two most important epochs in the sexual life of woman, 
the coming and going of the menstrual period, are 
marked by increased susceptibility of the nervous sys- 
tem." It is at this time that the delicate nerve fibrils 
are under such great tension that their vibrations are 
diffused over the entire system, until the strain is too 
great, a snap, a broken link, and relaxation comes on. 
Such shocks are too much for our American women. 
Nervous invalids are numerous about us, persons who 
are frightened at every sound, jump and start at the 
slamming of a door, and whom the sight of a mouse 
throws into a cold perspiration. The reason is easily de- 
throned and subordinated by the superior influence of 
easily excited emotions. The age of puberty is a critical 
time in the life of our daughters. Too much care can not 
be bestowed on their training at this time. Their brains 
should not be overtaxed, for premature and excessive 
mental activity dwarfs the bodily growth and enfeebles 
the functions in general. Ambitious at school, they are 
permitted to crowd on all the studies possible, late hours 
are required to master these lessons, not enough sleep is 
allowed to restore the loss. Soon from the bright rose- 
buds, promising and robust and healthy, they become 
pale and anaemic, the rosy tints fade from their cheeks, 
irregular and painful menstruation comes on, insomnia 
fastens its hideous grasp upon them. They droop and 



336 REFLEX VEVR08E8 IN WOMEN. 

fade, and at last grow into nervous women, with 
an inheritance of all the reflex neuroses of their ances- 
tors settled upon them. This is a sad but true picture 
of our girls at this age. We, as guardians of their health, 
should call a halt ere it is too late. Again at the meno- 
pause, we meet with many of these cases of exaggerated 
nervous troubles. It is at this stage of woman's life, 
after climbing the rugged hill thus far on life's journey, 
a change may come, the path may lead on up to good 
health, or a turn in the road may carry her rapidly down 
to the grave. 

I have time here only to briefly mention the other va- 
rieties of reflex neuroses. The cerebral, exhibiting it- 
self in the different kinds of headaches so often met with 
at the time of menstruation. The gastric, exhibited in 
vomiting of pregnancy, functional paralysis, vascular, 
pharyngeal and laryngeal, bronchial, intestinal, renaJ, 
vesical, glandular, ophthalmic, aural, lingual, the articu- 
lar neuroses, the reflex dermatoses, hysteria, hystero- 
epilepsy, spinal, and the cardiac. Often women consult 
us for imaginary heart disease, and it is sometimes a 
very diflScult matter to convince them of their true con- 
dition. The vagus, an important tract, is in direct con- 
nection with the ganglionic centere, and carries the uter- 
ine impulse to the heart, resulting in functional irregu- 
larities; while pain and distress about the heart are 
often reflected from the digestive tract. Women are 
easily alarmed and become flrmly impressed with the 
fear of sudden death. The troublesome cases of cystitis 
are met with in uterine displacements, lacerations of 
cervix, inflammations, and in pregnancy. 

Lacerations of the cervix and perineum are fruitful 
causes of these transferred impressions. Bight here, I 
would like to emphasize the fact that at everj/ child- 
birth, in primipara, lacerations of the soft parts occur, 
their extent varying in degree according to the resisting 
forces met with. I say this notwithstanding the fact 
that there are some doctors who say that they never have 
such accidents in their practice. They are wont to boast 
of their superior skill to their less fortunate brother. 
You may laud the merits of this or that kind of forceps, 
axis-traction, or what not, but these accidents will oc- 
cur in spite of the best care. He who tells me the 



EDWARD BURTON WARD. 337 

contrary has had very little experience, in obstetrical 
work or does not adhere very closely to the oath of Hip- 
pocrates to be truthful in all things. In cervical lacera- 
tions, the scar tissue left by nature in an attempt to re- 
pair the trouble is responsible for the nervous systems 
that ensue. Incarcerated in its fibrous grasp are nerve 
filaments, which furnish no end of refiex nervous symp- 
toms. In an operation on the cervix thorough removal 
of every particle of this dense mass is essential to com- 
plete success. Those cases of retro-displacements of the 
uterus attended by prolapsus, with a relaxed vaginal 
floor furnishing no support to prevent dragging on its 
ligaments, are only relieved by operation. The skillful 
gynecol(^8t can report many such results. As you have 
just listened to a paper on this subject it is unnecessary 
for me to dwell at length on these cases, although their 
importance is duly acknowledged. I wish now to call 
your attention briefly to those hete noirs in our practice : 
Hysteria, Catalepsy, and Hy^tero-Epilepsy. How often 
are we confronted with these trying cases, and how diffi- 
cult it is to control our patience under such circumstan- 
ces. This trinity i« peculiar to women, although I have 
met with it in men whose nervous systems are built on 
the feminine type. The definition of these troubles, 
"Emotion gone mad," is very expressive; another, a 
^^furor of the woml)," is suggestive. "There is no emotion 
without visceral reaction and the inordinate reaction of 
the sexual organs on a predisposed nervous system, 
shows itself by hysteria." In utero-ovarian diseases the 
hysterical paroxysms are brought on by pressure over 
the diseased organs, as easily, says one, as sound is pro- 
duced by striking the keys of a piano. We often pay too 
little attention to these cases, and sometimes diagnose 
as hysterical those which may be more serious. Many a 
poor woman's aches and pains are carelessly dismissed, 
with the expressions from us, *only reflex, functional, 
your disease is a phantom;' in other words, hysterical, 
though we dare not tell her in plain English, for if you 
wish to insult the dignity of woman accuse her of hav- 
ing hysterics. "The word Hysteria does often become 
to the doctor a will-'o-the-wisp, misdirecting his atten- 
tion from the real source of the nervous symptoms, which 
might have been once cured with comparative ease, but 



338 REFLEX NEUR08E8 IN WOMEN. 

have become deeply rooted in a debilitated constitution." 
I hope you will pardon me for relating a bit of personal 
experience along this line occurring in my younger days. 
I shall never forget the incident. It is indelibly im- 
pressed upon my memory. I was sent for to attend a 
lady who was subject to the worst kind of hystero-epilep- 
tic and cataleptic spells. Unfortunately for me, I was 
not familiar with her idiosyncrasies, and wishing, nat- 
urally, to give her prompt relief, I proceeded to admin- 
ister a hypodermic of morphine. Unfortunately, I let 
her know what I was going to give. She informed 
me that she could not take an opiate in any form ; that 
her old doctor, who had crossed over the river, was "be- 
yond the call of a hysterical patient, never would give it 
to her." Notwithstanding her protest I gave it, thinking 
it but a delusion of an overbalanced brain. In a very 
few minutes I was sorry for what I did, immensely so ; 
for no sooner had the needle been withdrawn than ofiE 
she went into the most fearful contortions, yelling and 
screaming, with an expression of horror depicted on her 
face, as she tried to escape the myriads of little devils 
that hovered around her, grinning in satanic glee. Soon 
she sank exhausted into a cataleptoid state. You can 
well imagine the state of my mind about that time. The 
cold perspiration began to creep slowly down my spinal 
column, my solar plexus wired its message of sympathy 
to my trembling epigastrium, my knees grew weak under 
me, my tongue seemed to cleave to the roof of my mouth, 
fear like a pall enveloped me. There she lay as inani- 
mate and as cold as a marble statue. I thought I had 
killed my patient ! I dare say many of you could repeat 
similar experiences. I would add that I have many times 
since given that same patient opiates, unknown to her, 
with no bad results. I would, however, say that I do not 
approve of the indiscriminate use of opiates in these 
cases, for sooner or later confirmed habits are established 
and the doctor is held responsible. 

Before I close this paper I would like to again speak 
of the importance of not treating too lightly and indiffer- 
ently the demands of these unfortunately afflicted indi- 
viduals. Although they try our patience, seemingly be- 
yond endurance, let us remember the proverb : "fifuatnter 
in modo, fortiter in re." That they do suffer both men- 



EDWARD BURTON WARD. 339 

tal and physical pain is true beyond a doubt. Phantom 
pains are sometimes more intense than real. Even if we 
find that there are no real pathological conditions exist- 
ing, it is OUT duty to minister to the mind as well as to 
the body. "The science of hygiene, if not the science of 
medicine, must, undoubtedly, in the future, give greater 
heed to these multifarious stimuli, for the sake of their 
effects." "In the liberality of an enlightened age, there 
may be but little surprise at newly discovered relations 
between man and the organic life around him ; yet in the 
cumulative knowledge of continued experiments the 
proximate cause of disease may be found at last within 
the grasp of scientific research, and modes of prevention 
become as important to man as are now the means of 
cure." "Any doctor," says a noted authority, *^an cure 
acute disease, nature does it for him, if he will let her 
alone ; but the highest test of skill is to cure chronic dis- 
eases of the reproductive organs." As peripheral irri- 
tation is a very decided factor in the production of reflex 
neuroses, treatment of course should be directed to re- 
moval of this irritation. The rational cure of these dis- 
tressing nervous phenomena is the real sedative women 
want and not the empirical use of drugs. The true phy- 
sician seeks to understand and to regulate the laws and 
phenomena of vitality; he is the pilot who guides the 
frail barque of human life through innumerable ob- 
stacles and perils, to the peaceful haven of health and 
safety. He is the high priest who enters into the most 
sacred precincts of domestic life. It is his duty to 
watch over the first day-spring of existence, and the last 
gleam of its setting sun. Not only is it his duty to keep 
vigil at the couch of pain, but to cheer the soul under its 
acute suffering, and alleviate the decay of nature; and 
it is a very difficult task sometimes to buoy up the hopes 
of patients reduced to despondency by repeated relapses. 



338 REFLEX NEUROSES IN WOMEN. 

have become deeply rooted in a debilitated constitution." 
I hope you will pardon me for relating a bit of personal 
experience along this line occurring in my younger days. 
I shall never forget the incident. It is indelibly im- 
pressed upon my memory. I was sent for to attend a 
lady who was subject to the worst kind of hystero-epilep- 
tic and cataleptic spells. Unfortunately for me, I was 
not familiar with her idiosyncrasies, and wishing, nat- 
urally, to give her prompt relief, I proceeded to admin- 
ister a hypodermic of morphine. Unfortunately, I let 
her know what I was going to give. She informed 
me that she could not take an opiate in any form ; that 
her old doctor, who had crossed over the river, was "be- 
yond the call of a hysterical patient, never would give it 
to her." Notwithstanding her protest I gave it, thinking 
it but a delusion of an overbalanced brain. In a very 
few minutes I was sorry for what I did, immensely so; 
for no sooner had the needle been withdrawn than off 
she went into the most fearful contortions, yelling and 
screaming, with an expression of horror depicted on her 
face, as she tried to escape the myriads of little devils 
that hovered around her, grinning in -satanic glee. Soon 
she sank exhausted into a cataleptoid state. You can 
well imagine the state of my mind about that time. The 
cold perspiration began to creep slowly down my spinal 
column, my solar plexus wired its message of sympathy 
to my trembling epigastrium, my knees grew weak under 
me, my tongue seemed to cleave to the roof of my mouth, 
fear like a pall enveloped me. There she lay as inani- 
mate and as cold as a marble statue. I thought I had 
killed my patient ! I dare say many of you could repeat 
similar experiences. I would add that I have many times 
since given that same patient opiates, unknown to her, 
with no bad results. I would, however, say that I do not 
approve of the indiscriminate use of opiates in these 
cases, for sooner or later confirmed habits are established 
and the doctor is held responsible. 

Before I close this paper I would like to again speak 
of the importance of not treating too lightly and indiffer- 
ently the demands of these unfortunately afflicted indi- 
viduals. Although they try our patience, seemingly be- 
yond endurance, let us remember the proverb : "Siiatnter 
in modo, fortiter in reJ^ That they do suffer both men* 



EDWARD BURTON WARD. 339 

tal and physical pain is true beyond a doubt. Phantom 
pains are sometimes more intense than real. Even if we 
find that there are no real pathological conditions exist- 
ing, it is OUT duty to minister to the mind as well as to 
the body. "The science of hygiene, if not the science of 
medicine, must, undoubtedly, in the future, give greater 
heed to these multifarious stimuli, for the sake of their 
effects." "In the liberality of an enlightened age, there 
may be but little surprise at newly discovered relations 
between man and the organic life around him ; yet in the 
cumulative knowledge of continued experiments the 
proximate cause of disease may be found at last within 
the grasp of scientific research, and modes of prevention 
become as important to man as are now the means of 
cure.'^ "Any doctor," says a noted authority, *^an cure 
acute disease, nature does it for him, if he will let her 
alone ; but the highest test of skill is to cure chronic dis- 
eases of the reproductive organs." As peripheral irri- 
tation is a very decided factor in the production of reflex 
neuroses, treatment of course should be directed to re- 
moval of this irritation. The rational cure of these dis- 
tressing nervous phenomena is the real sedative women 
want and not the empirical use of drugs. The true phy- 
sician seeks to understand and to regulate the laws and 
phenomena of vitality; he is the pilot who guides the 
frail barque of human life through innumerable ob- 
stacles and perils, to the peaceful haven of health and 
safety. He is the high priest who enters into the most 
sacred precincts of domestic life. It is his duty to 
watch over the first day-spring of existence, and the last 
gleam of its setting sun. Not only is it his duty to keep 
vigil at the couch of pain, but to cheer the soul under its 
acute suffering, and alleviate the decay of nature; and 
it is a very difficult task sometimes to buoy up the hopes 
of patients reduced to despondency by repeated relapses. 



340 REFLEX 8EN80RY AND MOTOR PHENOMENA. 



A STUDY OF REFLEX SENSORY AND MOTOR 

PHENOMENA, WITH REFERENCE TO THE 

COMPLETE DISTRIBUTION OF A 

NEURAL SEGMENT. 



By William T. Ec^et, M. D., Chicago. 



"A spinal nerve, including both the motor part and 
sensory part with its spinal ganglion, together with a 
portion of the medullarj; tube to which it belongs, repre- 
sents one neural segment.'- ( Barker. ) 

The object of this paper is, first, to recall to your minds 
some of the anatomical and physiological principles in- 
volved in reflex pain-phenomena which constantly pre- 
sent themselves to the practitioner; second, to urge a 
^eater uniformity of procedure in diagnosis, in inter- 
pretation of pain, in regions remote from the immediate 
cause of the pain ; third, to venture certain deductions, 
which, I believe, the present status of science will justify. 

Prior to the time of Hilton, who so enriched medical 
literature and elevated rational treatment, by his lec- 
tures on "The Therapeutic Influence of Rest and the 
Diagnostic Value of Pain," the phenomena of pain in 
a given part, due to irritation in some remote regions, as 
reflex toothache, due to a lesion in the uterus — ^were re- 
garded as an inexplicable sympathy that one organ had 
for another, when this latter was in trouble. 

Why the eyeballs and muscles of mastication should 
indulge in periodic nocturnal gymnastics and manifest 
such profound sympathy for the lower bowel, in case of 
irritation there, produced by x>arasites, not even the most 
speculative coflfee-house charlatan would venture to ex- 
plain. Very naturally, then, in harmony with the prev- 
alent ideas as to the causation of sueh phenomenal 
pains, in regions where no possible inflammatory action 
could be invoked to account for their occurrence, such 
deviations of common sensations were called "sympa- 
thetic pains" — an expression as current now, as then, in 



WILLIAM T. ECKLEY. 34I 

medical literature, but more scientifically explained. 

Hilton and his confreres explained the so-called sym- 
pathetic pains in the light of a projectile following its 
line of least resistance, along a tangible and demonstra- 
ble continuity of nerve-fibre, and in the following sen- 
tences announced the working formula for interpret- 
ing reflex pains. ( We are mindful of the facts of arbor- 
ization). "Sympathetic pains result from a continuity 
of nerves between the disease and the pain. As soon as 
we recognize the precise position of the pain, we are en- 
abled by a knowledge of the distribution of the nerve or 
nerves of that part to arrive, at once, at the only rational 
suggestion as to what nerve is the exponent of the symp- 
tom. Pain in any part, when not associated with in- 
crease of temperature, depends on a cause situated re- 
motely from the locality of the pain. If a patient com- 
plains of pain on the surface of the body, it must be ex- 
pressed by the nerve which resides there; there is no 
other structure that can express it, and somewhere in 
the course of its distribution, between its peripheral 
termination and its central, spinal, or cerebral origin^ 
the precise cause of the pain, expressed on the surface, 
must be situated. Superficial pain on both sides of the 
body, which are symmetrical, implies an origin or cause, 
the seat of which is central or bilateral ; unilateral pain 
implies a seat of origin which is one sided, and, as a rule, 
exists on the same side of the body as the pain." 

The principles advanced by Hilton regarding the dis- 
tribution of cutaneous and articular nerves, find their 
exact parallel today in the analysis of a neural segment, 
alongk the embryological line of man as a segmented 
creature. The telescoping of segments necessitates fre- 
quent communications of nerves and on this latter de- 
pends the irritation of pain which so often makes local- 
ization of a lesion very diflftcult. 

In these days of rapid operations, under powerful 
anaesthetics, and great precision in diagnosis, made so 
by the aid of chemistry, pathology, and transcutaneous 
photography, I am willing to admit that pain, as a sub- 
jective diagnostic symptom, may seem the same as 
"triflefi, light as air." 

To the patient, however, pain is the ideal of actual 
pathology, and to escape its recurrence how many take 
up their residence under the very shadow of the shrine of 



342 REFLEX 8EN80RY AND MOTOR PHENOMENA. 

Morpheus. Biologically, pain is an alert sentinel which 
first informs sensorium that the adjustment of the inner 
and outer relations is bad — that is a dull, complaining, 
local pain ; second, pain makes an appealing prayer for 
a speedy readjustment of inner to outer relations. This 
is a sharp, stabbing, lancinating, reflex, pain, over the 
nearest sensory nerve to the location of the disease; 
lastly, distances lose their power of resistance, all sen- 
sory lines tingle, all motor tracts are convulsed; this is 
the general irradiation of both pain and motion. 

In valvular lesion of the heart, there is reflex pain in 
the hand ; in disease of the kidney, there is reflex pain in 
the distal urethra; in diseases of certain pelvic organs, 
there is reflex pain in the distribution of the fifth cra- 
nial nerves. It seems a strange perversion, indeed, that 
the heart should belie hand ; that kidney should belie ure- 
thra ; that ovary should belie a tooth, but this is the pla- 
giarism of nerves, accounted for anatomically and phys- 
iologically, first, because sympathetic nerves do terminal 
work to the brain, over cerebro-spinal nerves ; second, be- 
cause sensory nerves, regardless of where they are irri- 
tated, always refer their sensations peripherally. 

There is no desire on my part to give pain an unten- 
able position in the diagnosis of disease, but to suggest 
a sympathetic line of rational procedure in locating the 
diseased organ, when cutaneous pain-data are present. 
So long as patients have painful diseases, so long as 
soothing applications to the exterior of the body react 
on internal organs corresponding to the same segmenta- 
tion ; so long as nerves in a stump ring up the brain and 
report pain in the great toe of a limb that twenty "years 
ago was amputated at the hip ; so long as physiology and 
the experience of physicians everywhere teach that 
stimulation of fifth cranial nerves and nipple may in- 
duce uterine contraction ; so long as Pflfiger's law of re- 
flex actions remains on record, I shall not consider the 
diagnostic value of pain obsolete. 

In the accompanying chart, for which I am indebted 
to Dr. Mortimer Frank, I have attempted to show the re- 
lation of the gangliated sympathetic cord and its prover- 
bial plexuses to the spinal nerves, in such a manner as to 
exemplify the fundamental principle in Hiltonism, that 
sympathetic pains result from a continuity of nerves 



WILLIAM T. ECKLEY. 343 

between the disease and the pain. On one side, the cones 
indicate the distribution of the spinal nerves to the body ; 
on the other, the corresponding sympathetic nerves to 
the cranium and prevertebral plexuses. 

In valvular lesion of the heart, an organ deriving its 
sympathetic nerve influence from the cardiac plexus, 
pain is experienced in the left little finger; the con- 
tinuity of nerve from the disease in the heart to the 
peripheral pain is along the cardiac plexus, cardiac 
sympathetic nerves, and brachial plexus, to the hand. 
The nerves that supply the cardiac plexus are visceral 
branches of the very nerves that form the brachial plexus 
and the base of the sympathetic cone corresponds to that 
of the somatic cone. In any painful disease of the heart, 
then, pain, if reflected, flnds its logical route along its so- 
matic correspondent, the brachial plexus. Let us re- 
member that in valvular disease, reflex phenomena may 
occur, then, in the fullest distribution of the brachial 
plexus; in any muscle supplied by this plexus; in any 
cutaneous region covering the muscle ; in any articula- 
tion moved by the muscle, or in any bone, cartilage, or 
fascia connected with muscles supplied by the brachial 
plexus. 

In like manner the pulmonary plexus corresponds to 
the 4 upper thoracic nerves, and in diseases of the lungs 
pain is reflected over these nerves and may manifest it- 
self in skin, bone, fascia, or articulation; reflex muscu- 
lar rigidity corresponding to the distribution of the 4 
upper thoracic nerves may also be present. 

The solar plexus corresponds to the 8 lower thoracic 
nerves, hence in diseases of the abdominal digestive or- 
gans, pain is reflected over this somatic route to the 
walls of the trunk corresponding to the cutaneous, arti- 
cular, muscular, and serous distribution of the 8 lower 
thoracic nerves. The renal sympathetic plexus corre- 
sponds to the lumbar plexus ; and all are familiar with 
reflex pain in the distal end of the urethra in renal cal- 
culus. 

The hypogastric plexus, from which the pelvic organs 
are supplied, corresponds to the sacral plexus; and 
many and interesting are the somatic reflexes in the dis- 
tribution of this plexus. 

The gangliated sympathetic cord communicates above 
with certain cranial nerves. Pains in the distribution 



WILLIAM T. ECKLEY. 345 

eases, which I have taken the time to look up, and I pre- 
sume they are used also in many other diseases, to the 
clinical histories of which I have not yet had time to re- 
fer: Pneumonia, pleurisy, bronchitis, pericarditis, endo- 
carditis, valvular lesion of the heart, angina pectoris, 
thoracic aneurism, renal colic, aneurism of abdominal 
aorta, spinal meningitis, locomotor ataxia, renal in- 
flammation, cancer of stomach, gastric ulcer, intestinal 
colic, enteralgia, acute enteritis, duodenal ulcer, intus- 
susception, strangulated hernia, parenchymatous hepa- 
titis, suppurative hepatitis, biliary calculi, ovaritis, and 
appendicitis. 

We interpret the route pursued by pain according to 
Hilton's laws, but we interpret the phenomena of reflex 
actions in general, according to Pfluger^s Law of Reflex 
Actians. 

1. If the reflex movement occurs on the same side on 
which the sensory nerve was stimulated, only those mus- 
cles contract whose nerves arise from the same segment 
of the spinal cord. Lastly, all the muscles of the body 
may be thrown into contraction. 

2. If the reflex occur on the other side, only the cor- 
responding muscles contract. 

3. If the contractions be unequal on the two sides^ 
then the most vigorous contractions always occur on the 
side which is stimulated. 

4. If the reflex excitement extends to other motor 
nerves, those nerves are always affected which lie in the 
direction of the medulla ; any reflex may be crossed. 

5. Extensive reflex movements and irradiating pain 
may occur under the following circumstances : 

1. When the discharging stimulus is very strong^ 

2. In case of exalted excitibility of the gray matter of 
the cord or brain, as in acute peritonitis, angina pectoris, 
spinal meningitis, Pott's disease of the spine, myelitis, 
and spinal irritation. 

A proper understanding of reflex phenomena on a uni- 
form basis would tend to smoothe many diagnostic as- 
perities. The logic in some cases of interpreting reflexes 
leads to the conclusion that equals are not equal, as the 
following case will show :A mother surrendered adiseased 
ovary, whereupon painful reflex phenomena in the 
distribution of the fifth nerve ceased permanently. An 8- 
year-old son of the patient was seized with grinding of 



.346 REFLEX 8EN80RT AND MOTOR PEBNOMENJL 

the teeth and convulsiye movements of the muscles of 
the eye ball, and later with severe pain in the ears. The 
grateful mother called on her physician, who wavered 
in diagnosis between ^^growing pains of childhood" and 
"hereditary nervousness." The physician, in the absence 
of a uniform logical procedure for interpreting reflex 
pain-phenomena, argued, doubtless, as follows: ^*Vir 
has no ovaries, therefore, the motor and sensory disturb- 
ances of the fifth nerve are due to maternal nervous- 
ness." A few years ago, I chanced to meet a member of 
the afflicted family, and learned that Vir had surren- 
dered his tonsils in Des Moines, la., his uvula in Sioux 
City, and, six months later, had been fitted with glasses 
by an oculist in Omaha, but had not regained perfect 
health until treated for pin worms by a specialist in 
Chicago. 

Medicine will reach ideal perfection only when every 
region of the body of the patient will be as painstakingly 
examined as our specialists are today capable of doing. 
The eye may be organically sound, but paralysis of the 
cervical sympathetic ganglia, or an injury to the spinal 
cord in the upper lumbar region, may reflexly induce 
ptosis, recession of the globe, and narrowing of the inter- 
palpebral fissure and pupil. Logically, pharyngitis is 
-complicated by lancinating pain in the eyeball , earache, 
and stiff jaw ; while toothache may be refiexly caused by 
functional or organic disease of almost any organ in the 
thorax, pelvis, or abdomen, because the adjustment of 
inner to outer relations of the nervous system is such 
that sympathetic nerves do terminal work over somatic 
nerves, and sensory nerves refer sensations to skin and 
articulations peripherally, the trigeminus being one of 
the most sensitive nerves in the body. Pain is a common 
sensation and differs only in degree from hunger, thirst, 
malaise, fatigue, horror, vertigo, tickling, well-being, ill- 
ness, and the feeling of free unobstructed breathing. In 
health there is a feeling of contentment incident to the 
physiological action of organs, and the brain receives 
the report "all is well" from abdominal and thoracic 
organs along sympathetic nerves doing terminal work 
over somatics. In disease, however, an opposite report 
reaches the sensorium, announced by darting, stabbing, 
pains. Where is the line to be drawn separating the re- 



WILLIAM T. ECKLEY. 347 

port, "all is well," from its painful opposite? In the for- 
mer, the brain enjoys the feeling of well-being, whose 
characters are not easily described; in the latter, the 
patient is racked with pain in the distribution of those 
very sensory nerves over which the visceral sympathetics 
do terminal work. Let physiology shed its light on this 
fine differential point, in a quotation from Landois and 
Sterling : 

"Pain may occur wherever sensory nerves are distrib- 
uted, and it is invariably caused by a stronger stimulus 
than normal being applied to sensory nerves. Every 
kind of stimulation, mechanical, chemical, as well as 
somatic, (somatic inflammation or disturbances of nutri- 
tion) may excite pain." 

The facts in the case are about as follows : Organs in 
the great cavities of the body are supplied principally 
by the sympathetic nerves, which are the visceral 
branches of spinal nerves ; they have a separate course 
from the intervertebral foramina to the organs, but in 
the spinal cord they do terminal work to the sensorium, 
over the axons of the spinal nerves. These sympathetic 
nerves rei)ort to the brain the feeling of well-being inci- 
dent to all the physiological functions of the body. In 
some cases malaise, vertigo, horror, and illness, are re- 
ported; from a conservative standpoint hunger, thirst 
fatigue, are reported. These various feelings are com- 
mon sensations, and differ, in degree only, from pain, 
which is also one of their number. 

In various organs the sympathetic reports to the brain, 
from different localities, in its characteristic adjectives : 
a sensation of weight, oppression, uneasiness, heat, burn- 
ing, dullness, pricking, distress, tenderness. The physio- 
logical difference between malaise and actual pain, then, 
depends on the intensity of the stimulation ; intensity of 
pain depends on nine conditions, one of which is the 
individual's nationality. Let us conclude that each pa- 
tient is a law unto himself, in regard to pain, and that a 
stimulus of given intensity that by one patient is called 
pain may be entirely ignored by another. In some cases 
of appendicitis there is "no pain," but there are no cases 
of appendicitis in which there is "no sensation." I will 
venture the assertion that any surgeon who has an oper- 
able case of painless appendicitis, if he will closelv in- 



348 REFLEX SENSORY AND MOTOR PHENOMENA. 

terrogate his patient along the line of "what kind of a 
sensation have you in the right iliac fossa?" instead of 
"have you pain?" will be able to give the world a new 
w^oM, by which to properly designate painless appendi- 
citis. Pain, as previously observed, is only one of a 
number of common sensations. 

If we interpret the course of pain as a projectile, ac- 
cording to Hilton, and estimate its multiform phenom- 
ena according to Pfltiger; if the intensity of pain depends 
on nine physiological propositions, varying in import- 
ance from nationality to particular nerves ; if there are 
two distinct varieties of pain, described by all authors, 
and if these two varieties of pain can be shown to possess 
diametrically opposite characters, and to emanate one 
variety from a sympathetic, the other from a somatic 
nerve; if pain is only one of a dozen common sensations, 
and in some cases may be supplanted by another sensa- 
tion; if pain is manifestly peripheral and its laws of 
manifestation are understood and appreciated as a sim- 
ple projectile in physics, and if pain figures conspicu- 
ously in the majority of diseases as a subjective symptom, 
I would ask : Is it not worth our time to revive princi- 
ples enunciated by Hilton, marshal the same in line, 
harmonize them with physics, physiology, and embryol- 
ogv, and decide on a uniform line of procedure in giving 
a universal interpretation of painful phenomena in 
those articular and cutaneous regions where there is no 
inflammation? 

It would seem that the same interpretation should 
be accorded to reflex pain-phenomena by all physicians ; 
I believe, however, such uniformity is not the case. I 
think it an exception, rather than a rule, to find a large 
percentage of physicians agreeing on the locality of a 
given irritation that produces a given reflex pain. Dr. 
K. reported to a local journal a case of intense pain in a 
sound molar tooth due to an ovarian tumor. Dr. L. re- 
plied to the report, averring that his collegiate training, 
as well as his professional experience in practice, had 
made him incredulous on the subject of post partum 
toothache in the pelvis. 

Dr. A. reports a case of valvular lesion, with darting, 
stabbing, pain in the little finger. No one sees anything 
out of the way in the report, because the traditions of the 



WILLIAM r. ECKLEY, 349 

profession and the empirics of generations recognize the 
little finger as a necessary partner in valvular lesion. 
Well, in a short time, Dr. A. chances to read a report of 
a case \iTPitten up by Dr. B. on the same subject. In this, 
however, the little finger was not in the case. On the 
contrary, the patient had intense pain in the shoulder, 
elbow, wrist, and finger joints, in conjunction with motor 
disturbances of the hand and forearm. Dr. A. could not 
believe Dr. B's report, because the traditional element 
of pain in the little finger was absent. Had each re- 
membered that muscle, skin, articulation, bone, fascia, 
vessels, and parietal serosa, may be the seat of the re- 
flexes, instead of a given cutaneous locality, Hilton's 
ghost might well be proud of Esculapius's sons. 

I believe adherence to these following steps would in- 
sure uniformity of interpretation : 

1. Local imin in skin or joint is reflex, in the absence 
of local inflammation, and its true source must be sought 
in the continuity of the nerve and its branches to both 
its somatic and visceral distributions. 

2. Determine the region of the spine from which so- 
matic nerves proceed to the painful spot, as indicated by 
the somatic cones on the chart ; then determine the group 
of organs supplied by "the corresponding sympathetic 
nerves, as indicated by the sympathetic cones. 

3. The muscles underlying the painful skin are rigid 
in proportion to the intensity of the pain; both skin- 
pain and muscular rigidity may be absent in some cases 
of inflammation of segmentally corresponding organs. 

4. Estimate the reflex route of the pain by nerve con- 
tinuity according to Hilton, the intensity and phenomena 
of pain according to established physiology. 

5. Bemember the full distribution of a neural seg- 
ment to both pre-axial and post-axial parts; to muscle 
and its investing skin and fascia ; to bone, cartilage, and 
unstriped muscular flbre ; to all movable articulations, 
serous membranes, and muscles, corresponding to a 
given segment. 

6. Local pain giving the sensations of weight, con- 
striction, fullness, uneasiness, heat, dullness, pricking, 
distress, tenderness, oppression, and burning, is sympa- 
thetic, and, after it attains a given intensity, may be re- 
flected over the corresponding somatic nerves as cutting. 



350 REFLEX 8EN80RY AND MOTOR PHENOMENA. 

shooting, gnawing, darting, tearing, intense, sharp, se-^ 
vere, aching, griping, boring, and fulgurating. 

Overlapping of segments. — Embryologically man is a 
creature of segments. One of the cardinal laws of seg- 
mented animals is the overlapping or telescoping of the 
segments. It may be impossible to distinguish where 
the cutaneous distribution of a superior nerve ends, and 
that of an inferior begins; but this is unnecessary, ex- 
cept for purposes of the speculative morphologist. There 
is always a center of maximal distribution of cutaneous 
nerves in which sensory reflex phenomena must occur, 
the malposition of organs to the contrary notwithstand- 
ing. The appendix may be under the liver, and faulty 
rotation of the alimentary canal may have placed even 
the entire colon on the left side of the body ; but these 
circumstances can in no wise alter the somatic routes 
over which pain must be reflected; at most, they alter 
the region of the local pain only. 

The intensity of pain depends, flrst, on the character 
of the nerve, somatic or sympathetic ; second, on the in- 
dividual nerve, some nerves as the flfth cranial, and in- 
ternal pudic being much more sensitive than others ;. 
third, on the number of nerve flbers involved in the irri- 
tation ; fourth, on the location of the irritation ; flfth, on 
the condition of the terminal end-organs of sensory 
nerves ; sixth, on the condition of the sensorium ; seventh, 
on the neuralgic temperament; eighth, on nationality; 
ninth, on unaccountable causes. Recently Dr. Small 
reported to the Chicago Medical Society two cases of 
appendicitis, in which ^th pain and abdominal muscu- 
lar rigidity were absent. Prom the standpoint of the 
physicist we must regard pain as a projectile. A projec- 
tile follows the line of greatest traction; second, the 
point of least resistance ; third, the resultant of the two. 
The line pursued by pain is continuity of nerve flber, 
in transit from a distant part of the body to the brain. 
When we see many clinical cases, as previously men- 
tioned, in which, as in angina pectoris^ the sympathetic 
pain is local and burning, and, later* witness this pain re- 
flected as most intense and lancinating into the chest and 
extremities, we instinctively inquire how may we logic- 
ally account for the rapid change in its character? Phy- 
siology answers: Intensity of pain is increased in pro- 



WILLIAM T. BCKLEY. 35I 

portion to the number of nerves involved ; and possibly 
this answer is correct. Still, I would like to ask the phy- 
siologist and histologifit whether or not the small size 
and frequent interruptions in sympathetic nerves are 
possible anatomical factors upon which the mild char- 
acter of local sympathetic pain depends? 

/ think it may he considered a general law that pain 
bears a direct ratio to the proximity of the inflamed 
region to, first, the excretory conduit; second, to the ser- 
ous covering of an organ. In both acute and chronic in- 
flammation of the kidney, the pain is dull in the back ; in 
renal colic, however, the prodromal pricking character 
of the local pain, doubtless, rapidly accentuated by the 
contractions of the ureter, soon becomes, by continuity, 
severe and excruciating in the penis and scrotum, and> 
by irradiation, into the abdominal and thoracic walls. 

In biliary calculi the prodromal symptoms of subjec- 
tive pain, when present, are those of local uneasiness ; as 
reflex phenomena, however, in the direct line of nerve- 
continuity, the pains are severe, cutting, and tearing in 
character in the abdominal walls and interscapular re- 
gion, and, by irradiation, in the thorax. Whether or not 
experience has proven that pain varies in intensity ac- 
cording as the hepatic, cystic, or common bile ducts are 
invaded, I leave the surgeon to answer. 

In suppurative hepatitis there may 'be serious, deep- 
seated, inflammation, without pain ; when, however, the 
inflammation is nearer the peritoneal surface of the liver 
the pain may be reflected to the right shoulder region. 

It may be well to remember that the similarity in 
symptoms between a twisted floating kidney and gall- 
stones, described by Brose, in a recent article, and quoted 
by Lee in a still more recent one, is due to an eflfort on 
the part of nature to preserve patency of an excretory 
conduit. The same symptoms may be experimentally pro- 
duced on short notice by artiflcially constricting bile 
duct, intestine, ureter, urethra, or great omentum. Lee is 
quite right in his assertion that ^Construction of any hol- 
low viscus in the abdominal cavity, as well as twisting of 
the great omentum, or a flbroid irterus" will produce a 
train of typical symptoms represented by pain, nausea, 
and vomiting, followed by local tenderness. Generalized^ 



352 REFLEX 8EN80R7 AND MOTOR PHENOMENA. 

the situation is as follows : Betardation of a free sym- 
pathetic nerve communication, between its prevertebral 
plexus and abdominal hollow viscera and the great omen- 
tum, is invariably followed by an effort on the part of 
nature to re^tablish the nerve communication, and the 
effort is attended by a chain of symptoms, as previously 
mentioned. The generalization will not be considered 
short-coming, I think, when we regard the great omen- 
tum, not in the light of a separate organ, but as an in- 
tegral part of the abdominal portion of the alimentary 
canal, peritoneal in derivation, but specialized to almost 
the same degree of intelligence as the Fallopian fim- 
briae in a manner most beautifully portrayed by Dr. 
Oschsner. The nictitating membrane of the eyes of some 
animals is an active organ of vision ; in man, however, 
its rudiment has morphological value only. 

In animals less liable than man to peritoneal infec- 
tion, the great omentum has morphological value ; but in 
man its function in limiting inflammation alone should 
entitle it to the highest place in intestinology, and its 
reflexes are equal in vivacity to those of any organ in the 
abdominal cavity. In the absence of local inflamma- 
tion, pains in bone are to be interpreted as an expression 
of physiological disturbance in some remote region, pos- 
sibly in the great cavities of the body. Is the unceri- 
monious bombardment of the patient with pills of proto- 
iodide of mercury, directed against bone pains, justifi- 
able in the absence of an incontrovertible history of 
syphilis? 

The functions of the sympathetic in highly specialized 
animals are indeed far-reaching ; reduced to its simplest 
terms this nerve is the custodian of the life organs, 
along the special line of apportioning nutriment to 
them according to their needs. Viscera, whose demands 
for sustentation are of such vital importance, derive 
their sympathetic influence from the prevertebral plex- 
uses, endowed with all but complete autonomy. The 
walls of the trunk and extremities derive their sympa- 
thetic influence through delicate nerves, the gray rami 
communicantes, which do terminal work over the so- 
matic nerves to these parts. It is the gray ramus that 
enables synovial and serous membranes to flood their 
respective cavities with fluid, flrst, for lubrication, and, 



WILLIAM T, BCKLEY. 353 

second, for the assumptive purpose of drowning out an 
intruder, as in tubercular tijdrops articuli. 

The gray ramus is equally concerned both in the 
growth and regeneration of bone by osteoblasts, and in 
its physiological and pathological removal by osteo- 
clasts. May not the "growing pains" of childhood be 
interpreted in a Fothergillian way as a demurrer from 
these connective tissue bony parts, which fail to receive 
their requisite amount of blood on account of sluggish 
activity of the gray rami? Growing bone- pains, how- 
ever, need no treatment ; but, in cases of tardy regenera- 
tion of bone, due to hereditary causes, is not the same 
priuoiple involved as in growing pain? The assumption 
of insufficient amount of blood will account for neither 
the pains in the one, nor the tardy ossification in the 
other, since each may occur in the well-nourished. The 
philosophical reason, then, must be sought farther back, 
first, either in a failure of the capillaries to deliver blood, 
or, second, the osteoblasts fail to appropriate the same. 
In either case the responsibility rests at the door of the 
gray ramus communicans, the custodian of the un- 
striped muscular fibre, bone, cartilage, fascice, osteo- 
blasts, and osteoclasts. 

In these days of such far-reaching clinical experience, 
is it assuming too much to venture the assertion that 
before another decade the clinician will tell us how to 
stimulate the gray rami through the great somatic nerve- 
trunks, and by hastening the bone-forming activity of 
the osteoblasts, add another triumph to medical science? 
Then the indefinite term "hereditary," which always 
promptly changes its name when the light of anatomy 
and physiology reveal its true identity, will be relegated 
to the rapidly-growing list of obsolete and meaningless 
words in science. Then will the "growing pains of child- 
hood" be regarded as sympathetic refiex pains over so- 
matic routes ; and tardy regeneration of bone as slug- 
gish osteoblasts in need of a stimulating tonic. 

In inflammation of the visceral pleura, the cutaneous 
pain and tenderness will correspond to the distribution 
of the four upper thoracic nerves. Here, too, possibly, 
pains in the articulations between the ribs and verte- 
bi'de, behind, and the ribs and sternum, in front, must be 

83 



354 REFLEX 8EN80RY AND MOTOR PHENOMENA. 

taken into account. In the inflammation of the parietal 
pleura the pain will be in both the thoracic and abdomi- 
nal walls. In inflammation of the diaphragmatic pleura 
pain should be manifested in the distribution of the cer- 
vical plexus. Stiff necky immobilization of the depres- 
sors of the hyoid bone, burning sensations in the part of 
the ear supplied by the great auricular nerve would be 
rational symptoms. 

Hilton thus generalizes pain in the back : Firsts per- 
sistent pain in upper one-third coexists, as a rule, with 
disease of the heart, aneurism of the aorta, disease of tra- 
chea and bronchi, and stricture of the sBSophagus in the 
posterior mediastinum; second, persistent pains in the 
lower one-half of the interscapular region are, as a rule, 
associated with diseases of the abdominal digestive 
organs ; third, lumbar pains are associated with disease 
of the ascending and descending colon, kidneys, ureters^ 
lymphatic glands, testicles, and ovaries. Reflex pains 
from the ovaries and testicles should occur in the distri- 
bution of the lumbar plexus ; those for the prostate and 
uterus, in the distribution of the sacral plexus. In either 
case the phenomena of pain may be manifested in the 
fifth cranial nerve. 

Pain in the scalp, behind, in the region supplied by the 
great and small occipital nerves, says Hilton, in the ab- 
sence of local inflammation, is reflex, and in all proba- 
bility due to disease between the flrst and second cer- 
vical vertebrae. Pain in the rest of the scalp must be 
sought, first, by examining the distribution of the fifth 
nerve; second, by interrogating organs supplied by the 
sympathetic, in which case the pain is reflected upward 
along the gangliated sympathetic cord. 

The penis may be the seat of numerous motor and sen- 
8 >rj reflexes. The nerves are : First, the genito-crural 
to the skin of the base of the organ; second, the internal 
pudic ; third, the hypo-gastric plexus. 

The genito-crural nerve corresponds to the sympathet- 
ic nerve-supply of the kidney, hence, irritation from this 
source will be reflected, flrst, as pain in the penis ; second, 
as retraction of testicle. Anatomically, pain in the tes- 
ticle should be an early symptom in renal calculus. 

The internal pudic nerve supplies the greater i)art of 
the integument and the entire glans penis. This nerve 



WILLIAM f. ECKLEY. 355 

also siippliep the rectum, vagina, ischio-rectal fossa, ae 
well as the muscles of the perineal region. It will be ap- 
parent that reflex pain in this organ presents numerous 
diagnostic obstacles, on account of the immense distri- 
bution of the internal pudic nerve. The rectum, it should 
be remembered, may be the seat of a small irritable fis- 
sure. The irritation of this may cause a persisting 
tingling of the glans, suggestive of renal or vesical cal- 
culus. A subacute inflammatory action in the ischio- 
rectal fossa may do likewise. 

In all pains of the penis, where we can exclude local 
irritation, we should bear in mind the erogenous quali- 
ties of the internal pudic nerve. 

Pain, we must remember, is a common sensation and 
may occur wherever sensory nerves are distributed. It 
is produced by a stronger stimulus than normal. The 
normal stimulus of the cerebral sexual center produces 
a common sensation called "sexual instinct" ; a stronger 
vita sexualis produces pains which are reflected along, 
its line of least resistance — the internal pudic nerve j 
exceptionally, however, the sensation may be reflected 
over the entire distribution of the sacral plexus, and 
this may account for the secondary erogenous areas. 
A few days ago, a prominent surgeon told me he had a 
patient with extreme pain in the penis, and in whom he 
was unable to diagnose vesical or renal trouble. I am^ 
sure the gentleman will not operate upon the case till 
he has interrogated the entire distribution of the inter- 
nal pudic nerve and inquired into both the primary and 
secondary erogenous areas of his patient. 

The Trigeminus and Internal Pudic Compared, 

It is a matter of physiology that the trigeminus is 
the most sensitive cranial nerve ; it is equally true that 
the internal pudic is the most sensitive spinal nerve. 
The trigeminus guards the portals of smell, hearing, 
taste, sight, and mastication; the internal pudic — 
those of procreation and extrusion. The trigeminus is 
attended by white rami communicantes from the thor- 
acic region of the cord which confer dilatation on the 
pupil, motion to the involuntary fibres of the eyelids 
and orbit, and vaso-motor fibres to the head ; the inter- 
nal pudic receives in its distribution morphologically 



356 REFLEX 8EN80RY AND MOTOR PHENOMENA. 

the same, under the name "nervi erigentes," which are 
vaso-dilator to the generative organs and motor to the 
longitudinal muscular fibres of the rectum. Each 
nerve haa very extensive primary and secondary reflex 
communications, both somatic and sympathetic, and 
each has a strong affinity for the other. The internal 
pudic is the trigeminal nerve of the pelvic outlet. 

A malodorous, irritating, invader of the nasal fossae 
is promptly put to flight by reflex sneezing, in which 
case, the afferent nasal branches of the flfth nerve, a 
cerebral transfer center, and the motor branches of the 
cervical plexus form the reflex arc. Through the 
sympathetic, the nasal mucous membrane participates 
reflexly. A primary reflex is conflned to one nerve; a 
secondary reflex originates in one nerve and terminates 
in another. A grain of sand in the eye produces reflex 
lachrymation ; a severe toothache may produce a flxed 
jaw and pain in the auditory canal. These are reflexes 
within the flfth nerve, hence primary. Retraction of 
the general cavernous structures of the penis in the 
virile reflex, elevation of the testicle in the cremasterio 
reflex, and genu-extension in the patellar reflex, are 
examples of primary reflexes in the internal pudic, 
genito-crural, and anterior crural nerves, respectively. 

I believe it is a rule in biology to which there are no 
exceptions, that the oriflces of the body are guarded by 
the most sensitive nerves — the flfth cranial and internal 
pudic discharge this custodianship, therefore, they are 
the most sensitive nerves of the body. It is also a mat- 
ter of fact that these two nerves owe their great affinity 
for each other, flrst, to intimate association of function ; 
second, to some obscure and not yet explained relation 
which each nerve bears to the special senses. In sup- 
port of this view it is only necessary to refer to sexual 
psycopathic phenomena, in which the pelvic parts 
supplied by the internal pudic nerve respond to sight, 
smell, audition, and gustation. The bond of union be- 
tween the flfth nerve and the internal pudic is the gan- 
gliated cord, and the cause of marvel is, not that there 
may be "toothaches in the pelvis," but that there are 
physicians living who deny the possibility of such re- 
flex phenomena. Irritation of the gums in teething 
produces reflex vomiting. 

Arnold, a bean in the ear produces reflex vomiting. 



WILLIAM T. ECKLET. 357 

Fox, pruritus in the ear produces reflex vomiting. 

Fox and Ronibergy a pyorrhoea alveolaris ppoducen 
gastritis. 

Salisbury, an ovarian tumor produces intense pain in 
a sound central incisor. 

Hunger, irritation of nipple, tooth, brachial plexus^ 
produces contraction of the uterus; and, conversely, in 
endocarditis produces reflex pain in the distribution of 
the auriculo-temporal branirh of the fifth nerve. (Lan- 
dois. ) 

On reflex contraction of the uterus, Mrs. C B. Eckley 
writes in The Woman^a Medical Journal for June, 1900^ 
as follows: 

The nerves of the uterus are from the third and fourth sacral, 
from the hypogastric and renal plexuses; the two latter also supply 
the ovary and fallopian tube. 

contraction of the uterus normally occurs at the menstrual 
period and at the end of gestation. Premature contraction of the 
uterus in the course of gestation may produce the dire consequences 
of a miscarriage. The uterus will contract reflexly on stimulation 
as follows: 

1. Stimulation of the hypogastric plexus. 

2. Stimulation of the nervi erigentes. 

3. Stimulation of the nipple. 

4. Stimulation of the trigeminus. 

5. Stimulation of the sacral plexus. 

6. Stimulation of the great sciatic nerve. 

7. stimulation of the lumbar plexus. 

8. stimulation of the brachial plexus. 

9. stimulation of the inter-costal nerves. 

The hypogastric plexus, better known as the pelvic plexus or 
inferior hypogastric, supplies the rectum, bladder, prostate in the 
male and vagina and uterus in the female. In the female it lies on 
each side of the rectum, bladder and vagina. Branches from this 
plexus accompany the arteries to the pelvic organs and take the same 
name as the arteries. This plexus is continued down from the supe- 
rior hypogastric plexus in the lumbar and upper sacral region. It is 
Joined by branches from the third and fourth sacral nerves, and 
from the sacral part of the gangliated sympathetic cord. The nervi 
erigentes, called by Gaskell the pelvic splanchnics, arise from the sac- 
ral plexus. They contain vaso-dilator fibres, and stimulation of the 
nervi erigentes, which may be brought about through stimulation of 
the sensory nerves of the clitoris, produces erection. In this way 
contraction of the uterus may be induced by stimulation of the nervi 
erigentes. These nerves also supply the rectum. 



358 REFLEX SENSORY AND MOTOR PHENOMENA. 

Aloln catharsis is looked upon with disfayor in pregnancy, on ac- 
count of its action on the lower bowel, and its consequent liability 
to induce uterine contraction. Mistempered and mistimed injec- 
tions, rectal and vaginal, are abortifacient and are often resorted to 
with criminal intent In those cases reflex-action is through a 
purely sympathetic circuit. 

The time honored Crede's manipulation of the fundus uteri 
through the abdominal walls, in sluggish contractions, is a re- 
source in obstetric practice too familiar to all to need comment. A 
painful bunion in one case and a fractured patella in another, have 
Induced miscarriage by reflex contraction of the uterus. The intelli- 
gent and conscientious dentist declines to operate on the teeth of 
pregnant women. The evanescent nature of the neuralgias of preg- 
nancy is appreciated even by the laity. Putting the child to the 
breast to aid Indirectly In producing uterine contraction, has and 
will be in favor for all time to come. So great has become the con- 
fidence of the profession in the action on the uterus of stimulation 
of the nipple, that by a sort of logic by default we think of a sym- 
pathy between these two organs, founded on some sort of structural 
co-relation or similarity. So in the light of anatomical analysis let 
us compare the uterus and nipple. 

The uterus is a muscular organ seated In the pelvis; the mammary 
gland is a compound racemose secreting structure situated on the 
major pectoral muscle. The uterus derives its blood supply from the 
internal iliac artery; the mammary gland from the subclavian. The 
uterus derives its nerves from the sacral and hypogastric plexuses; 
the mammary gland from the intercostal nerves and cervical plexus. 
The uterus is a derivative of Muller's duct, a supposed invagination 
of the mesothelium of the body cavity; the mammary gland is trace- 
able to epidermal cells in common with ordinary sebaceous glands. 

The so-called sympathy between uterus and mammary gland, must 
be sought in coincidence of the respective functional activity of the 
two organs. The functional activity of the uterus gestates a ferti- 
lized ovum, and initiates the life of a new being, hungry the moment 
It arrives; the mammary land gestates lactation. Initiating the nu- 
tritive process by a mild laxative, baby's flrst medicine. 

There is a wonderful correspondence indeed between the delivery 
of the child and the consummation of lactation, but this correspond- 
ence is paralleled by other physiological processes, the out-put of 
distinctly removed anatomical organs from each other between 
which lay and physicians never intimate even the possibility of 
sympathy. I refer to the separation of urea from the blood in the 
kidney, and its conduction through the ureter to the bladder, from 



WILLIAM T. ECKLEY. 359 

which 148 final ellmlaatlon from the body takes place; to the reflex 
action of olfactory and gustatory nerres on the salivary glands and 
the simultaneous action of the stomach In making preparation for 
the reception of food; to vicarious functions of skin and mucous 
membrances when kidney and uterus respectively are temporarily 
Incompetent to carry on elimination of deleterious products. 

Reduced to Its simplest terms, the case Is this, a pregnant woman 
submits to a dental operation Involving pain and In consequence of 
stimulation of the fifth cranial nerve uterine contractions occur pro- 
ducing a miscarriage; the uterus Is at one end of the sympathetic 
gangllated cord, the fifth cranial nerve Is at the other, but why 
should the Irritation respond on the muscular fibre of the uterus? 

Both common observation and physiology teach us that when one 
system of organs Is active, other systems are held more or less In 
functional abeyance. Great and prolonged mental activity conduce 
to dyspepsia; on the other hand a full stomach surprises the brain. 
Great orators and vocalists of reputation can testify to the benefit 
of an empty stomach. This Is manifestly so because each organ, 
when active, requires a certain amount of nerve-force, and the fewer 
organs calling for nerve-force the greater the power of concentra- 
tion of the major nerve force along one particular line. If you give 
the stomach an hour's time for uninterrupted digestion mental work 
may be resumed with Its accustomed ease. Very clearly, the organ 
most vigorously acting Is the one toward which the nerve-force Is 
defiected — It Is then the point of greatest traction, and the only way 
of rationally estimating the remote consequences and Importances 
of this deflection of nerve force, lies in the line of 1. functional Im- 
portance of the organ; 2. length of time over which its function ex- 
tends. The Importance of gestation need only be referred to be ap- 
preciated. Physical, mental and even moral changes in the preg- 
nant woman are in evidence on every hand. The length of time ex- 
ceeds that of any other functional activity. Is it strange then that 
nausea and vomiting, the capricious appetite, the dropsical efhislon, 
the Jaundice and urticaria, and even the mania and murderous In- 
stincts of the pregnant woman are on record? 

Characters of pain: — The evidence from all sides 
converges to establish a duality of pain in connection 
with the majority of diseased organs; flpst, local, dull 
in character, and intensified on pressure; second, reflex, 
sharp and lancinating in character, and sometimes miti- 
gated by lErentle pressure. I quote from two sources — 
Lee and Harris. 



960 REFLEX 8EN80RT AND MOTOR PHENOMENA. 

Dr. Lee says : ^Tirst^ let us take in consideration the 
following eases: Renal colic and pyosalpinx, twisted 
pedicle of floating kidney, a twisted pedicle of a der- 
moid tumor, a strangulated omental hernia, pancreati- 
tis, acute hematokolpos or hematometra. In gall stone 
colic the initial symptom is pain. This is followed by 
nausea and vomiting, and later by local tenderness in 
the region of the gall bladder. The pain in the onset 
is diffuse and of a colicky nature. In renal colic, we 
have a similar train of symptoms; first, the pain of the 
colicky character, w^hich is always followed by nausea 
or vomiting, which, however, as a rule, is not as intense 
as in appendicitis or in gall-stone colic. In the greater 
percentage of cases of acute pyosalpinx the initial 
symptom is pain, which is of a colicky nature, is fol- 
lowed by nausea and vomiting, later by local tenderness 
in the pelvis, and by rise of temperature. In appendi- 
citis, as well as in other abdominal lesions, the pain in 
the early stage of the disease is of a colicky nature, and 
due to an acute distention of the organ affected; and 
the greater the distention, the greater the pain. 

Second, as soon as the constriction or the distention 
has subsided, or the obstruction has been relieved, .the 
reflex colicky pains and vomiting cease, and the pains 
that are present after this time are of a steady character. 
They should be described more as a tenderness in the 
right iliac fossa and are due to the circumscribed peri- 
tonitis. 

Third, this last mentioned pain gradually subsides 
as the disease progresses toward its favorable termina- 
tion, either by perforation of the abscess into the bowel, 
or possibly by the absorption of the circumscribed in- 
flammatory process." 

Of pain in renal calculus, Dr. Harris says: 

*'*The pain is of two kinds, acute intermittent parox- 
ysms, which are so familiar to all under the name of 
renal colic, and the dull, more or less constant ache in 
the lumbar region or the latero-abdominal region. This 
pain is usually increased by exercise, and may radiate 
in most any direction, downward to the bladder, up- 
w^ard to the costal region, across the abdomen, or into 
the thigh. Morris, in his "Renal Surgery," mentions 
Bome very interesting and instructive cases showing the 



WILLIAM r. ECKLEY. 361 

bizarre character which the pain of renal calculus may 
at times assume. One of the most important features of 
the pain is that it may be rarely located on the 
side of the body opposite the kidney aflfected. Such a 
case is mentioned by Tuckerman. The pain and tender- 
ness were both on the opposite side; Battle mentions a 
similar case. Persistent pain in the latero-lumbar re- 
gion, which is otherwise unaccountable, should always 
excite a suspicion of renal calculus. Tenderness over 
the region of the kidney, or along the ureter, is often, 
present, and may be of some importance in determining 
the side affected. 

RESUME. 

1. Pain is a projectile, and, as such, is governed in 
its course by the law of projectiles in physics. 

2. Pain reported to the sonsorium by sympathetic 
nerves alone, is dull, heavy, and local, and conveys a 
sensation of weight and uneasiness. 

3. Other common sensations, as hunger, thirst, ma- 
laise, fatigue, and the sensations incident to the physi- 
ological actions of organs, are reported to the brain by 
the sympathetic. 

4. Pain on the surface of the body or in articula- 
tions, unaccompanied by local elevations of tempera^ 
ture, is reflex, and due to continuity of nerve fibre be-^ 
tween the pain and the local irritation. 

5. Each typical neural segment supplies the mus- 
cle segment, the corresponding skin, and serous seg- 
ments, the vessel segments, and the inter-segmental 
septa, such as ribs and cartilage, and pre-vertebral or- 
gans corresponding to the segment. It consists of, first, 
a visceral part to organs ; second, a somatic part to the 
trunk and extremities. 

6. Pain in any organ may be reflected via the rami 
communicantes into the somatic part of the neural seg- 
ment and induce sensory reflex pains in the skin, parie- 
tal serous membranes, and articulations, and motor 
phenomena in voluntary muscles. 

7. Where a reflex pain is studied for diagnostic 
purpose, each joint and serous meml)rane, as well as 
each muscle supplied by the same neural segment^ 



302 REFLEX 8EN80R7 AND MOTOR PHENOMENA. 

should be interrogated, as well as the skin, for reflex 
phenomena. 

8. In organic diseases of viscera there may be two ya- 
rieties of pain; first, local, which may be identified by 
pressure, and which is described by authors as a sen- 
sation of weight, oppression, dullness, burning, and un- 
easiness, etc.; second, reflex, more or less remote from 
the diseased locality, in the skin, bone, or articulation, 
and described by authors as sharp, cutting, stabbing, 
boring, tearing, fulgurating, etc. ; and may be partially 
Telieved by pressure. 

9. The bones, cartilages, and unstriped muscular 
flbre of the trunk and extremities, are supplied with 
the gray rami communicantes. The gray rami communi- 
cantes travel with somatic nerves and are set aside spe- 
cifically as custodians of the osteoblasts, osteoclasts, 
bones, fasciae, and unstriped muscular fibre. 

10. The internal pudic nerve and the trigeminus are 
the most sensitive somatic nerves in the body, because 
they guard the somatic orifices; they are in strong af- 
finity with and related to each other principally on ac- 
-count of some psychic cause not demonstrable ; the gan- 
gliated sympathetic cord between the two is a tangible 
line, both of greatest traction and least resistance, and 
there are no refiexes between the parts supplied by the 
•two nerves, which can not be explained by the funda- 
mental principle of Hiltonism. 

DISCUSSION. 

Dr. R. M. Cunningham: The two papers just read 
are exceedingly interesting and practical. The paper of 
Dr. Eckley embraces the fundamental principles of the 
subject to which it relates and is unique in literature 

If there is anything that is known to physiologists it 
is the physiology of the nervous system ; if there is any- 
thing that the general medical profession knows little 
about it is the nervous system. 

These papers can be read with great profit and I hope 
will be read by the members of the Association when they 
•appear in the volume of Transactions. 

I regret that Dr. Eckley could not be present to read 
this paper in person. 



LOUIS WILLIAM JOHNSTON. 363 



ACUTE ENTEROCOLITIS IN INFANCY. 



Bt Louis William Johnston, M. D., Tuskicgee. 
Senior Counsellor of the Medical Association of the State of Alabama. 



No subject is more important, especially at this period 
of the year, than that of Acute Entero-Colitis in Infancy. 
As physicians we are often called upon to combat this 
disease — so dreaded by mothers — and, unfortunately, in 
many instances, find it occurring among the poorer 
classes, where, alas ! so often asepsis and other valuable 
therapeutic measures are unobtainable. 

When we realize the great mortality of this disease, 
being greater than that of any other acute disease of 
childhood, our minds naturally turn to prophylaxis, 
than which no more promising field is open to investiga- 
tion and study. 

Prophylaxis should aim at the solution of two distinct 
problems : ( 1 ) The removal of the causes which inter- 
fere with the proper growth and development of chil- 
dren. (2) The prevention of infection. The former can 
come only through the education, first, of the profession, 
and then, of the general public, in the fundamental prin- 
ciples of infant feeding and hygiene. This is a depart- 
ment which has received altogether too small a place in 
medical education. The latter must come through the 
profession and through legislation, the purpose of which 
shall be more thorough disinfection, and improved sani- 
tation in all departments. 

Entero-eolitis is a disease of the hot months and of the 
period of teething, though not confined to either. Ex- 
posure to cold and damp, the sudden suppression of per- 
spiration, over-crowding, over- feeding, and irritating 
contents of the bowels, are the most common exciting 
causes. It may be secondary to any of the infectious 
diseases, particularly measles, diphtheria, and broncho- 
pneumonia. 

We are still in doubt as to the part contagion plays in 
the production of the disease. Booker found that the deep- 
er lesions were almost invariably associated with the 
presence of streptococci, but whether they are primary or 



364 ACUTE SNTERO-COUTIS IN INFANCY. 

secondary is not easy to determine. AmcBbse have been 
found by Cahen and others in the stools of typical cases, 
but thus far too few observations have been made to ad- 
mit of any deduction. 

PATHOLOGY. 

The morbid changes are found chiefly in the ileum and 
colon. In the first stage, the mucous membrane is con- 
gested and swollen. In places, the epithelium appears 
exfoliated. After the first week the enlarged follicles 
and Peyer's patches become ulcerated. The disease may 
end here, or become more extensive, the ulcers enlarging 
and deepening to the muscular coat, with the separation 
of a slough. Or, there may be a diffuse infiltration of the 
coats of the bowel with small cells, producing a decided 
thickening of the same, with more or less obliteration of 
their distinct structure. The process may be so intense 
as to cause coagulation-necrosis — false membrane. (Ty- 
son.) The liver and portal circulation are always en- 
gorged. 

SYMPTOMS. 

This affection shows many grades of severity, propor- 
tionate to the extent of intestine involved and the inten- 
sity of the inflammatory process, the symptoms varying 
accordingly. There is increased languor, great fretful- 
ness, and fever. The early catarrh is attended by green, 
acid stools, with lumps of casein. At first, the tongue is 
furred and moist. It soon becomes red and dry, and 
vomiting ensues. The stools are offensive and frequent ; 
and, in addition to the appearance first indicated, con- 
tain mucus and blood. Death may take place within the 
first week on account of exhaustion from the vomiting 
and diarrhoea. If the disease is protracted it is attended 
by great wasting, symptoms of hydrocephalus, skin erup- 
tions, hypostatic pneumonia, and extremely weak circu- 
lation. A sudden rise of temperature in the course of an 
attack would point to some complication, or to extension 
of the inflammation to new areas. The head and the 
nervous system are generally only slightly affected, 
though we sometimes have twitching and convulsions. 
The stools vary in number from two to twenty or thirty 



ACUTE ENTERO'COLITIS IN INFANCY. 365 

per diem. In severe and protracted eases the stomach 
becomes greatly disordered , nausea and vomiting are 
troublesome and the breath is sour, offensive, and, at last, 
even fetid. The lips and teeth are covered with sordes. 
€k)licky or griping abdominal pain is a quite constant 
«ymptom. Tenderness on pressure is usually present. 
Tympanites is a common symptom. Considerable en- 
largement of the abdomen occurs in cases in which the 
muscular coats of the intestines have become weakened 
or paralyzed by the inflammation. Tenesmus and pro- 
lapsus ani are not uncommon. In mild cases improve- 
ment may commence in the course of two or three days 
and easy convalescence be established. Even in these 
cases, however, relapseis easy from indiscretion of diet or 
mild exposure. In the severer cases, the course is often 
prolonged to from three to six weeks. There is more 
pyrexia. The diarrhoea is increased. The tongue be- 
comes dry, red, or brown, the face anxious, cold, clammy, 
-and purplish; and the pulse small, weak, and rapid. 
Hiccough occurs and cannot be relieved. The patient 
lies on the back with knees drawn up. Death may occur 
from asthenia, septicsemia, or perforation and peritoni- 
tis. Slow and tedious convalescence may occur, or the 
disease may assume the chronic form. 

DIAGNOSIS. 

Acute entero-colitis is to be distinguished from cholera 
infantum, acute dyspeptic diarrhaea, typhoid fever and 
intussusception. From cholera infantum it differs in 
its lower hyperpyrexia, and in the absence of vomiting, 
colliquative diarrhoea, and of collapse. It is character- 
ized by greater severity than acute dyspeptic diarrhoea, 
and by high fever, the large amount of mucous in the 
stools, the greater pain and suffering, and the more rapid 
decline. Typhoid is usually distinguished by its more 
constant fever, the enlargement of the spleen, the tym- 
panitic distension of the abdomen, and, most of all, by 
the eruption. The fact of an epidemic prevailing is also 
to be considered. Intussusception is marked by a very 
sudden onset, the amount of blood is quite large, often 
as much as a tablespoonf ul ; there is vomiting, sometimes 
persistent, with marked prostration, but no fever ; stop- 
page of bowels, abdominal tension, tympanitis, rising 



366 ACUTE ENTEROCOLITIS IN INFANCY. 

temperature, stercoraceous vomiting and collapse, all 
different from the phenomena of dysenteric colitis. 

PROGNOSIS. 

It is never safe to give a positively favorable prognosis 
until the end of the hot season, on account of the great 
liability of these cases to relapses and recurrent attacks. 
Cases occurring in June or early in July have a worse 
prognosis than those occurring in the latter part of 
August or in September, for the reason that the earlier 
cases have still the greater part of the summer to get 
through, and are likely to suffer from relapses during the 
rest of the warm weather. In cities, among the poorer 
classes, and in institutions , and in the presence of any 
complication, the prognosis is still less favorable. The 
particular symptoms which make the prognosis bad are 
a continued elevation of the temperature, frequent vomit- 
ing, rapid wasting, and continuous, severe, nervous symp- 
toms. Do not give up the little patients too quickly, for 
I have seen cases where all hope was lost, the children 
becoming too feeble to swallow, but by feeding with the 
stomach tube, and by inunctions of oil or lard the vital 
forces would rally and recovery take place, 

TREATMENT. 

Having laid down the important hygienic rules of fresh 
air, frequent bathings, cold cloths, and not too frequent 
feeding as preventive means of this disease, Chapin thor- 
oughly discusses the subject of its treatment. Bearing 
in mind that a majority of the cases are caused by milk 
poisoning, all forms of milk should be temporarily with- 
held. In the interval, water may be frequently given,* 
with the addition of a little lime water. If the stomach 
tends to reject it, reduce the quantity. Many a case 
would be stopped at the very beginning if milk were 
entirely with-held for from twelve to forty-eight hours. 
When this is necessary for any length of time other 
forms of nourishment may easily be substituted. The 
white of an egg stirred in half a glass of cool water forms 
a pure and easily assimilable albumen water. The only 
objection is its tastelessness, but Chapin overcomes this 
by the addition of about two drops of aromatic spirits of 



LOUIB WILUAM JOHyBTON. 367 

ammonia. When there is a tendency to vomit the am- 
monia seems to check the stomach irritation. Among 
other substitutes for milk may be mentioned thin gruels, 
made from barley or wheat flour, broths, beef juice ; also 
some of the prepared milk foods. I use one preparation 
more than all others at this period, namely, the beef 
peptonoids with creosote, and I have seen very few stom- 
achs reject it. Not only do I use this preparation for 
sustaining the patient but for the beneficial effect of the 
creosote, which I think is the ideal antiseptic in these 
cases. I will call your attention to this later. When 
the acute symptoms have subsided and milk is resumed 
it must be taken at long intervals and with high dilution. 
With regard to drugs : I think if the patient has been sick 
for several days before a physician is called in, and, as 
is usual^ you find high temperature, I would always 
use stomach lavage and high enemeta with normal salt 
solution, unless the patient is very nervous and excit- 
able. Then follow with calomel, one-tenth of a grain 
every hour, with 15 to 30 drops each of liquid phos-soda 
and elixir of pepsin, until six or eight doses have been 
administered. These small doses act as a sort of stimu- 
lant to the bowel, increase glandular secretion, and usu- 
ally effectively clear the canal of its fermenting contents* 
A good size dose of castor oil is also effectual, and is fol- 
lowed by a sedative effect on the mucous membrane. 
After you have flushed the alimentary tract, place a baby 
of from six to twelve months on from 10 to 20 grains of 
the subnitrate of bismuth in a weak creosote emulsion 
about every 2 or 3 hours. 

The insoluble quality of bismuth and its sedative local 
effect make it most valuable. Irritation and fermenta- 
tion, even under proper dietetic management, remain 
long in the ileum and colon, and this tract is reached by 
the local action of the bismuth. The creosote has a spe- 
cial sedative action upon the nerves of the stomach, and 
allays irritability and nausea« Being a superior antisep- 
tic it exerts its germicidal effect through the whole ali- 
mentary tract, and the secretions seem to keep up better 
under its influence. We are not so likely to have compli- 
cations when we keep patients under the influence of 
creosote. Fever is best controlled with cold applica- 
tions, or baths. I always advise the use of some antisep- 



368 ACUTE ENTSROVOLITIS IN INFANCY. 

tic mouth wash. For relieving the nervous symptoms, 
and frequently when sufferings 10 to 30 drops of bro- 
midia by the rectum, well diluted, gives splendid results. 
Anodynes should be tried before using opiates. 

Opium is contra-indicated until the bowel has been 
thoroughly emptied of irritating contents; especially 
when the stools are scanty and foul-smelling, and when 
cerebral symptoms threaten. In cases, however, in 
which rapid peristalsis and profuse glandular secretion 
persist, a few moderate doses of opium are most valuable. 
It should never be combined with other drugs. Small 
doses of aromatic spirits of ammonia, say 10 to 20 drops 
well diluted with water seem to stimulate the mucous 
membrane and refresh the infant. Alcohol should be 
given very sparingly in these cases, as it seems to lower 
the digestive powers. In cases of great weakness, or 
collapse, from 10 to 30 drops of whiskey, well diluted, 
may be administered. If the discharges are profuse and 
exhausting, and the baby sinks into a semi-stupor, with 
depressed fontanelle, very free stimulation with whiskey 
and ammonia is indicated, as spurious hydrocephalus is 
thus ushered in. Hypodermoclysis has been used with 
beneficial results in such conditions. In case of collapse, 
hot injections (110 to 115 degrees P) have been advised, 
and in case of high temperature ice water may be used 
with advantage. In using enemata for local effect the 
intestines should first be emptied by an ordinary saline 
solution, except when nitrate of silver is to be used ; then 
simple wat^r should be employed. The clyster is used 
about half an hour afterwards, and should not be over 
2 to 6 ounces, slowly introduced, the buttocks being 
pressed firmly together and thus held for twenty to forty 
minutes. For use in this manner the following sub- 
stances are to be preferred, (1) Bismuth suspended in 
mucilage ( jss to ?i ) from four to six ounces to be in- 
jected, (2) Tannic Acid (Grs xx to 31 > same quantity 
of vehicle to be used. (3) Nitrate silver (Grs fr to 3I) 
in four ounces of water. (4) Boracic Acid ( ji ) in 
four ounces of water, and (5) Bland mucilaginous mix- 
tures, with opium. For tenesmus, suppositories con- 



DISCUSSION. 369 

taining half a grain of cocaine sometimes act like a 
charm. Dr, J. H. Kellogg, of Battle Creek, advises the 
use of the hot blanket pack to produce dilatation of the 
cutaneous vessels, and then follows this by a cold wet 
hand rub, or by placing the child in a sheet wrung out 
of cold water, with the addition of a blanket to prevent 
chilling of the patient. In case of persistent vomiting^ 
the use of gastric lavage and the application of an ice bag 
over the stomach is recommended; for the control of fre- 
quency of stools, the use of an enema at 105 to 110 de- 
grees following each stool ; also the use of fomentations 
to the abdomen for ten to. fifteen minutes every two or 
three hours, followed by the application of a heating 
compress consisting of a towel of cheese cloth wet in cold 
water and covered by two or three thicknesses of flannel. 
During convalescence it is better generally to stop all 
treatment with reference to the bowels and to direct our 
efforts to genera] tonic measures. 

DISCUSSION. 

Dr. W. W. Harper : We must first recognize the fact 
that this is a contagious disease. We know it is due to 
germs which inhabit the intestinal tract. These germs 
enter the mouth as an open door and reaching the ali- 
mentary canal begin to manufacture toxins. It occurs 
more frequently in children who are artificially fed, 
therefore, it becomes important for the physician to edu- 
cate the people to understand that children nursed 
naturally are the children that are going to be healthful. 
I am sorry to say that society is such now that mothers 
do not care to nurse their children. They should remem- 
ber that there is no higher sphere in life than for a wo- 
man to be a mother. Where it is impossible for the 
mothers to nurse their children, then, we should impress 
it upon them to see that the milk supply is from a health- 
ful source. In the treatment of this affection I want to 
insist upon with-holding milk. It should be with-held 
twenty-four or forty-eight hours. Instead of opiates, I 
believe we can relieve the nervousness by phenacetine, 
not reduce the temperature, but relieve the nervousness. 
I want to put myself on record as being opposed to intes- 
tinal antiseptics. They are absorbed before they reach 
the seat of the disease. 

24 




f/r. T. D P:»rii^: Ir i» imt the 
*?! • i^istm^, \r ]m -Ju* milk. Tmi 
,i«M. f/r. Harper ^p^tk^ '>f wtrii-ibiifinc tie milk 

A^ ^ >^.<>nr. ^^ri»«ii sniidi -^uL th^a was csiki^ wnJk 
^fkn^^Mr>x^. n.trJi twnp^farm^ binmfy amiioaft. €te. I 
JkM *Iv»: ^/^nfUti>ti«»^ of rhe CatflLl'j ami <>r4eRd xSmt Ar 

**h,,#1 ft^ n^hint^ hnt waTi*r, 5ow, I fcriie^i^ the fUM 
ir^ni4 !ui^^ ^:H lidd I tM'TTL Ton wbbA kcve bo fnr aC 
^i>rr:rtaf ^*\\Af^!ny and I innisitrthat yya 
fA ^>hdr»ir rh«^ foM of i^idltiri^n aulfqLi ig fro^ 




fJT. «lohiii5it/j« fr-IogROfti : I oqIt wiik to 
th^ impr^rt^iK^ #>f ^iiratiii^ mothers to tke CKt 
f-UVAr^^ ^n liTfr wirh^mt nnniiM; eterr balf hovr. As 
f/f ffpi^tjf^^ I har#!r n^n bad effects from them in these 
&f9fi^^. It M better tr> 0Te amae anodjner but ssoaDx 
irri((HlUn$ quielM the ehild. 



WHAT IH THE BEST CLOSURE AND DRESSING 

IN ASEPTIC CASES? 



Bt Oaumn Kme, M. D^ StoJiA. 
§mii(rr CovfiMllor of the Medical AsMxrlatlon of Oie State of Alfthaine. 



Tho be^t cU>iiure is a nnion of peritonenm with peri- 
ttftu'umf rnnscle with muflirle^ fascia with fascia, fat with 
tnlf II nd Mkiti with skin, by buried, continnooSy animal 
Mtitiiri'N. 

What are the best nuture materials, and methods to 
tiNe tn snrh a cloiiure? The best satnre materials are 
rni^iiti iit<>rlli7.eil by the method of Dr. John O. Clark, 
ft ml knnKaroo tendon, prepared under the supervision of 
Dr. Henry O. Marry. The best, because of facility and 
uniformity of use as a continuous suture, they cause no^ 



GOLDBB7 KJNQ. 871 

irritation^ hold the tiasues in exact approximation until 
firmly united, permit no separation of the scar nor her- 
nia, necessitate no removal, become absorbed, "and pari 
p<i88\x with their absorption a living band of connective 
tissue cells replaces the whole line of the suture/' 

The good qualities of silver wire, and silk-worm gut 
are easy, perfect, and x)ermanent, sterilization, and such 
a hold upon the tissues that a separation of the incisioo 
is impossible. The bad qualities of silver wire, and silk- 
worm gut are : Impossibility of use as a continuous 
suture, except for the union of skin with skin ; they cause^ 
occasionally, such irritation that makes their removal 
imperative ; they do not become absorbed, hence their re- 
moval from the skin becomes necessary. 

Silk is easily and perfectly stmlized by the method of 
Dr. W. B. Halsted, but is unfitted for use as a buried 
suture, because, when buried, it becomes encysted, and 
may cause an irritation at any time. 

What is the best method to use in such a closure? 

The best method is not to unite all the layers by inter- 
rupted sutures, with its danger of infection, its faulty 
coaptation of layer to layer, its discomfort of irritating 
sutures, and their removal, and its stitch abscesses, and 
painful and unsightly scars. 

The best method is to unite the peritoneum by a con^ 
tinuous suture of fine catgut. The union of muscle to 
muscle, and of fascia to fascia is best obtained by the 
use of the continuous double kangaroo tendon suture^ 
after the method devised, and so long practiced by Dr. 
Henry O. Marcy. The fat is best united and dead spacer 
avoided by a continuous cat gut suture piercing the fat 
from side to side. The best union of the skin is by a sub- 
cuticular cat gut suture, which should be buried in the 
tough corium, and not penetrate the epithelium. 

What is the best dressing in aseptic cases? 

The silver foil dressing, as worked out and practiced 
by Dr. W. S. Halsted, is without doubt the best dressing 
m aseptic wounds, closed by buried sutures. 

It is superior to the collodion seal, and all other dress- 
ings, by reason of its germicidal properties, its close and 
permanent adhesion to the skin, its perfect occlusion, 
and its non-irritating qualties. An abundant gauze 
dressing should be next applied, and this should be held 
in place, and muscular movements restrained, by a Scul- 
tetuis bandage. 



372 G0LD8BY KING. 

What are the advantages and results of this closure 
and dressing? 

Only one dressing is required, and that at the time of 
the operation, when aseptic precautions are the best. 
The safety of such a closure was well illustrated in a case 
of severe typhoid fever, in which an operation for appen- 
dicitis was done. A few days after the operation, a gan- 
grene of the fat and skin began between the external lip 
of the crest of the ilium and the inferior border of the 
twelfth rib, and, advan<:ing rapidly from right to left, 
swept over the incision, and was arrested at the median 
line. 

The skin and fat were removed, but the buried kanga- 
roo tendon sutures held the fascia and muscles firmly, 
and the wound soon presented a healthy, granulating but. 
face. A month after the operation this patient died of 
repeated hemorrhages from the bowels. 

The advantages of the closure of a lacerated perineum 
by buried kangaroo tendon, in layers, with an occlusive 
dressing, are so many and so great that it must soon be 
universally used. 

The results of the methods herein described are ideal . 
The abdominal incision is so absolutely free of any sen- 
sation that no patient of ours has ever been able to cor- 
rectly locate it. The incisions have united per primam, 
without exception. Neither a hernia, nor a stitch ab- 
scess, has ever followed. There have been no painful nor 
unsightly scars. The temperature has not usually been 
higher than one hundred, and that for only one or two 
days. 

In conclusion, permit me to emphasize two truths : 

First, that a buried animal suture should always be 
used as a continuous suture as, by this method, material 
is economized and knots and constriction of tissues 
avoided. 

Second, and most important, one should never use 
buried sutures nor an occlusive dressing, unless he is ab- 
solutely sure of the surgical cleanness of himself, his 
assistants, his materials, his surroundings, and of the 
perfectness of his hemostasis. 

DISCUSSION. 



Dr. W. H. Hudson: The paper jijst read is inter- 
esting and improving. I agree with the author as 



DISCUSSION. 375 

to the method of closing wounds. I would hesitate to> 
use cat gut, unless cumolized. As to the silver foil, it 
must be sterilized and this cannot be done in a short 
time and when done requires a great deal of heat. la 
reference to uniting wounds in appendicitis, it is ad- 
visable to stick to silver wire, but when you expect an in- 
fection use cat gut. For the present we will have noth- 
ing that will improve on the silver foil. I am sure that 
Dr. King's paper has been appreciated. 



PATHOLOGICAL CONDITIONS CAUSING ABOR- 
TION AND PREMATURE LABOR, WITH 
REPORT OF CASES. 



By Francis A. Webb, M. D., Calyebt. 
Member of the Medical Association of the State of Alabama. 



Looking back over an experience of nearly twenty 
years, I can recall no class of cases the treatment of 
which has caused me more anxiety and doubt, or in re- 
gard to which I have found it more difficult to get satis- 
factory rules from books or consultation, than the patho- 
logical conditions that cause abortion and premature 
labor. 

It is not my purpose to discuss all of the pathological 
conditions that cause abortion or premature labor ; time 
would not permit, nor would it be profitable to do so. 
My purpose is to present in a practical way a few cases 
that have come under my observation, with the hope of 
provoking a general discussion and exchange of opinions* 

For convenience I will designate the cases, A. B. 
and C. 

Case A. Multipara — aged 27, mother of three children. 

This patient consulted me during the month of Febru- 
ary. Her last menstrual period occurred in December. 
She had menstruated regularly up to that time. In Feb- 
ruary the flow had returned, was profuse and watery^ 
and accompanied with more pain that usual. She 



374 ABORTION AND PREMATURE LABOR. 

thought she was pregnant^ but could not understand the 
return of the flow^ nor its profuse, watery, character. 
On inquiry I learned that -she had never aborted, the 
family history was good, there was no specific trouble, 
but she had suffered a good deal from dysmenorrhoea be* 
fore marriage, though not since the birth of her first 
child. On further examination I felt assured that my 
patient was pregnant and threatened with abortion, 
fihe was ordered sedatives, cautioned to keep her bed for 
several days and to avoid all exertion. 

My instructions were carried out to the letter, but the 
flow returned in about two weeks, the pain more severe 
and the flow watery and more profuse; Consultation 
was then requested. My consultant agreed with me both 
as to diagnosis ( Hydrorrhoea Gravidarum with threat- 
ened abortion) and treatment. The main reason for 
consultation was to discuss whether further efforts 
should be made to prevent the premature expulsion of 
the foetus, or whether nature should be assisted in her 
efforts to throw it off. I could see that my patient, from 
confinement to bed and the repeated profuse discharges, 
accompanied with pain, ansemia, and great anxiety was 
growing weaker every day ; and that the foetus, from lack 
of nutrition, could hardly be expected to survive, even if 
carried to full term. My^ consultant admitted all this, 
but believed it best to let nature have her way and make 
further efforts to prolong the pregnancy. The patient 
was cautioned to keep her bed and the usual treatment 
ordered, to prevent, if possible, the threatened trouble. 
Notwithstanding the best efforts on the part of patient 
and physician, the pains and the profuse discharge would 
recur every week or ten days, and, just as gestation 
reached the seventh month, premature labor came on and 
resulted in the delivery of a poorly nourished male child, 
which survived only a few minutes. 

My patient, by a confinement to bed of over three 
months, loss of appetite, profuse fiow, anxiety, etc.. had 
so run down that it was by a narrow escape she passed 
through the ordeal of labor. It required months of tonic 
treatment to restore her to health. 

It is my honest conviction that it would have been 
good practice and justifiable to have terminated this 
threatened trouble earlier, and thus to have enabled my 



FRANCIS AMBURY WEBB. 375 

. jwtient to avoid many doses of medicine, and, aboye all^ 
to escape the danger that threatened her life. 

Case B. Multipara. — Mother of three boys. Young- 
est child, six years oM. 

I was called June 3rd to see this case. She gave the 
following history: Had menstruated last in January; 
her former pregnancies had been normal; had never 
aborted. For two days prior to my visit she had suf- 
fered from pains and hemorrhage. She believed she was 
five months pregnant and that the trouble had been 
brought on by over-exertion. 

On examination I found the os slightly dilated. There 
was yet considerable pain and hemorrhage. Diagnosis : 
Accidental hemorrhage from placental detachment, 
caused by violent exercise, and, as a consequence, threat- 
ened premature expulsion of the foetus. The patient 
was confined strictly to bed and put on treatment, to 
arrest, if possible, the threatened trouble. I was sent for 
again on June €th. She had not obeyed instructions 
in regard to the recumbent position, but had gotten up 
that day and had a return of all the symptoms. She was 
again ordered to keep her bed and the treatment was con- 
tinued. The patient remained in bed after this, but had 
hemorrhage and pain again on the 11th. I was sent for 
and saw the case with Dr. J. T. Searcy, as a consulting 
physician. He advised that we still temporize and con- 
tinue the treatment, at the same time expressing the 
opinion that the case would eventually terminate 
in a premature expulsion of the child, but thought 
best not to interfere. I was called again in great 
haste on the 29th, this time to find the patient in 
active labor, the os well dilated and a very foul 
discharge flowing from the uterus and vagina, the 
patient with a rapid pulse and temperature of 
103 degrees. The fcetus was expelled, dead and al- 
most decomposed ; the placenta, also, in a state of decom- 
position. The uterus and vagina were washed out with 
an antiseptic solution and the patient put on ergot, 
sti^chnia, and quinine. For several days her condition 
was critical from septic trouble, but she eventually 
recovered. 

The pathological condition causing this premature la- 
bor was : Separation and detachment of the placenta^ 
followed by pain and hemorrhage, and, as a consequence. 



376 ABORTION AND PREMATURE LABOR. 

mal-nutrition of the child, and, finally, its death and de- 
composition. 

My conyiction is that had the uterus been emptied on 
my second yisit, June 6th, my patient would have had a 
much better chance for life ; the danger from the decom- 
posing child and placenta and consequent septic trouble 
would have been less, or altogether averted, and her 
physical condition would have been much better able to 
withstand the ordeal. With a patient five miles away, 
with an extensive country practice to look after, you can 
imagine the anxiety of the physician; and also of the 
I)atient, under such circumstances. 

Case C. Multipara — Mother of two children ; young- 
est twenty-three months old ; had never aborted. I was 
consulted May 4th and she gave the following history: 
Prior to December 20th she had menstruated regularly. 
Her menses did not appear on January 20th. She had 
had a profuse leucorrhoea since December. On March 
17th she had a fall, followed, immediately, by pain in left 
side and uterine region, also, by a profuse watery dis- 
charge from uterus and vagina. This watery discharge 
continued for several days. On April 5th she menstru* 
ated (as she thought) profusely, the fiow continuing for 
five days, accompanied by severe pain. Then, for the 
week following, there was a dark, muddy, offensive dis- 
charge. On April 26th she again had a flow for three 
days. This flow had the appearance of blood , and some 
clots were expelled. On vaginal examination, I found 
the uterus enlarged and flexed toward the right side. 
The OS was not then dilated. Owing to the thick abdomi- 
nal walls, it was not easy to ascertain the exact size of the 
uterus. From such data, and well-knowing that several 
pathological conditions might furnish a similar history 
and produce many of the symptoms detailed, diagnosis 
was no easy matter. Several possibilities existed : First, 
That the woman was impr^nated in the month of De- 
cember and had aborted on March 17th (date of the fall 
and profuse watery discharge), the foetal envelopes hav- 
ing been retained ; or she was still pregnant, the amniot- 
ic fluid having escaped and tiie uterus having contracted 
down on the retained foetus and envelopes. 

Second. The condition might be due to sub-involu- 
tion, with menstrual irregularity. 



FRANCIS A8BURY WEBB. 37T 

Third. Chronic corporeal endo-metritis, or chronie 
corporeal metritis might exist The eroded os uteri and 
profuse leucorrhoea were symptoms of this condition. 

Fourth. The enlarged uterus and irregular menstrua- 
tion might be due to a sub-mucous fibroid. 

Fifth. We might have a case of ectopic gestation- 
In this condition we have signs of pregnancy^ cessation, 
of menstruation, or, the flow is replaced by peculiar 
hemorrhages ; nausea, yomiting, and capricious appetite 
are noted. Some of the mammary signs, such as in- 
crease in size of nipple and glandular follicles, pigmenta- 
tion, oedema, and elevation of the primary areola and 
enlarged veins, are often present. Pelvic discomfort is 
marked; indeed, compared with ordinary pregnancy 
these symptoms are often more pronounced. Hemor- 
rhages from the uterus are apt to occur in gushes of 
larger or smaller amount, and are especially liable to ap- 
pear at the time of menstruation, and with marked pain. 
The hemorrhages and decidual clots often suggest abor- 
tion or premature labor. 

A decidual clot is often thrown off, and this cast has 
no foetal villosities. It may be discharged entire or by 
piece-meal, and shreds must be looked for. 

The patient suffers from paroxysms of pain, which are 
abrupt and violent, supervening in apparent health, 
cramp-like in character and usually referred to the fruit 
sack, while the more acute symptoms are attended with 
collapse and signs of internal hemorrhage. On bi- 
manual examination the uterus is found : first, enlarged; 
second, is displaced according to the size and situation of 
fruit sack ; third, the cervix is open ; fourth, the uterine- 
cavity empty. The tumor, which is detected beside the 
uterus or behind it, is a cyst, (1) tense (2) tender, (3) 
pulsating, (4) rapidly growing. This tumor is exceed- 
ingly sensitive. There is extraordinary pulsation, which 
can be easily felt. 

After a careful study of the history of the case, and 
all that could be ascertained by vaginal examination, the 
diagnosis and line of treatment were not clear; conse- 
quently, I requested consultation. Dr. G. Owen kindly 
consented to examine the case with me. Next day, ( Ma j 





a ;i4» «iv i»^ ';uir ';&«( 3ant*iir ^>^f^ J«*r 

jpr**^ Mfvrtp* I ';k*i*^ /it* .«>«)a ati p«ififiiui4t ^i liut tdjk Zic 
ir; »^ ^^r^'^ufk ,u<ii 0f<i 4«immiiii#^L <m ::ne rune ^V3» iu 

^/»n#l .#»n »f 'Vij.^ijVw^ ami ^tiii^tiL I r«Hnii . Ti»*fi vizii 
>Ax V * r'^T^iov^^j *ai^ n-4»np*ia aii«t w<watifi .joe tie va- 

fr\ouw',\ ft//t /'^rt^ift, AM;v#ri;/h j#r>mfrof cbe .47aipt:«iaii»aiid 
tU4^ u.At/,rj f,t \\%fr ^ajw^ *'O0i4 lead tf> *ii24pi*:if>a '^f etriopLi: 

hn^. hr, Wili'iJim M. MaMtio wsuk fraii^i in ciiiL^TiIiacAW 
wi^li HM At^\ sitxt<r #rxa.rn>&atioo apresmed hinLself as noc 
Mrijift^/J, a A h^ roiii/l of^t in the patient'^ extremeij low 
tou^Ution mak^r rf^ f-arfrfiil ezamioacioa he wished. Ebe 
r*'</;\ri\f'f\ t h^ ^;i>t^ aj* ohi^r rire, with H^>ine symptonLS point- 
\uyi Up i^'th\tU' iif-nt^tUru, hilt the prep«>Qderance of efi- 
4U'Uf'^ %Hnf in Uin opinion, that the tronble was intra 
ut4'riuK tfr. ManfJn a/lvJMeri that aa iioon as the patient's 
f'/fiKlirJoo morild fiermit, fihe be removed to the PtotI- 
4U'Uff' tufiruiHrVf put uwU'.r an ameHthetie, the ntems in- 
f4'nttUitU'f\^ the #li;s((n/miii dearnl op, and if the trouble 
WfiH tomnl to h«; ffXf ra uterine, tr> operate. May 13th the 
pMf ient wan rifnoved to the Infirmarj. May 14th, it was 
AKPHul that Dm. Owen, 3Iastin, Webb, Marshal, 
iinlfwn^ am] Thomas mer;t at the Infirmary to clear up the 
iUsifitumiHf and operate, if necessary. The patient had 
been well prepared for the examination and operation, 
II ml i'Vi'ry thin^ waM in readiness, when Dr. Mastin tele- 
phoned that It would be impossible for him to be present 
After conNultatlon it was agreed that we had best not de^ 



FBAJfCIS ABBVMJ WBBB. 379 

lay the examination. Ether was administered by Dr. 
Mar^chal. Dr. Owen requested Dr. Thomas to make a 
Taginal examination. Dr. Thomas said that the uterus 
was larger than normal , but he was not sure of the 
<;ause. The patient was then brought to the edge of the 
table, the uterus dilated, with GoodelPs steel dilator, 
and with some difficulty I succeeded in passing my finger 
through the internal os and found a foetus in utero. It 
had been agreed if the diagnosis proved that the cause 
was intra-uterine to pack the neck of the uterus with 
iodoform gauze, tampon the vagina and let nature expel 
the foetus. This was done and the patient put back to bed. 
She came out well from under the ether, and rested well 
all the evening and during the night. Later on, the 
pains came on and the patient was delivered of a dead 
foetus, of five or six months. She eventually made a 
£Ood recovery. 

It is my honest conviction that when cases pre- 
sent the history and the symptoms of the three, 
just outlined, it is the plain duty of the physician not to 
procrastinate, but, ueing every antiseptic precaution, to 
make a thorough and decisive examination of the uterus, 
4uid, if necessary, empty it I believe in conservatism 
and the old adage "meddlesome midwifery is bad," yet, 
when the patient's life is in danger from threatened 
hemorrhage that may occur mt «ay moment, or when her 
health is impaired from long confinement, and there is 
great risk of septic trouble, it is our duty to act, and not 
increase the jeopardy by an attitude of so-called masterly 
inactivity. 

Were it necessary the reports of similar cases could be 
multiplied. The three just selected from my note book 
are ample, however, to demonstrate the truth of my first 
proposition, namely, that great difficulties surround the 
class of cases of which I speak, to overcome which it is 
often not easy to find advice, either from books 
or consulting doctors. I would not be understood 
to rashly advocate the emptying of the uterus from 
any and every pathological cause, without due de- 
liberation and consultation; but I do condemn the 
procrastination so often practiced both by attending phy- 
sician and consultant. Indeed, it is my opinion that 
every pregnant w^oman whose case presents a pathol(^- 
ical condition should be regarded with the same care and 



\ 

380 YOUTHFUL AND INSANE CRIMINALS. \ 

I 

treated on the same principles that govern modem scieir^ 
tific surgery. My contention is that after due delibera- 
tion and consultation we should meet these pathological 
?onditions causing abortion and premature labor witb 
timely and scientific help. 



NEEDED REFORMS IN THE MANAGEMENT OF 
YOUTHFUL AND INSANE CRIMINALS. 



By William Olassell Somebville, A. B., M. D., Tuscaloosa. 

Trustee of Alabama Insane Hospitals. 
Member of the Medical Association of the State of Alabama. 



Some one has said ^^he prisoner is a moral and 
physical patient^ more or less curable^ and we must 
apply to him the great principles of the art of medi- 
cine. To a diversity of ills we must apply a diversity 
of remedies." Thus^ it is to the physician, and not to 
the moralist and lawmaker, that society will have to 
look for the repression and correction of vice and 
crime. 

There are two great causes which make every man 
what he is, viz., Heredity and Environment. That 
the moral disposition for good and evil, including crim- 
inal tendencies, love, hatred, courage, and cruelty, 
are transmitted from parents to children, or from one 
generation to another, has been proved, and is as 
firmly believed by all scientific men as the fact that 
parents transmit to their children the physical quali- 
ties of beauty, color of eyes, or hair, and shape of nose. 
As there are exceptions to physical transmissions, so, 
there are exceptions to the transmission of moral 
qualities. Occasionally, we find a son or daughter 
totally unlike either father or mother in physical ap- 
I)earance, while, on the other hand, we find one child, 
the so-called "black sheep of the fiock," who evinces 



WILLIAM GLABSBLL BOMERYILLE. 381 

marked criminal tendencies. The question naturally 
arises, why this difference? Why does not the law of 
heredity hold good? Our answer to this would be 
that these are apparent exceptions, and that from 
some former generation this moral obliquity comes, 
latent, it may be, for several generations, but retain- 
ing its potential energy, and, perhaps, nurtured by 
^external influences, until finally, it makes its appear- 
ance in some unfortunate one, handed down to him 
as a legacy from an erring ancestor. The mental and 
moral deficiency in the parents does not necessarily 
manifest itself in the children in the same form. In 
one generation we find insanity, in another epilepsy, 
or some other neurosis; some may have strong crimi- 
nal tendencies, or are defective in moral sense, — in 
short, they are degenerates. As Maudsley so aptly 
expresses it, "there is a destiny made for a man by 
his ancestors, and no one can elude, were he able to 
attempt it, the tyranny of his organization." 

There are many who recognize hereditary influence 
in animals, but fail to recognize it in man. Occasion- 
ally, we find in a litter of puppies one who differs en- 
tirely from the parents and the others, either in color 
or mental qualities. When we wish to buy a horse, a 
cow, or a dog, we are governed to a great extent by 
the qualities of the parents, — in other words, pedi- 
gree is the controlling infiuence. The history of a 
remarkable family, known as the "Jukes," has been 
traced through seven generations, including 709 per- 
sons, every one of whom was a thief, robber, murderer, 
prostitute, or lunatic. 

When we speak of environments, we use the term 
in its broadest sense, including education in general; 
mental and moral, religious and social, physical and 
political conditions. Hereditary influences are co- 
eval with the beginning of mankind, and will be felt 
to the end. Environment and education are the powers 
and circumstances which are to a greater or less ex- 
tent modifying heredity in the present and future 
generations. By proper environment and education, 
along with social reforms, ancestral tendencies to 
vice can, to some extent, be overcome, and much done 
to prevent the increase of the defective and degenerate 
classes. 



382 YOVTSFVL AXD 1N8ANS cntMtJfALS. 

With every mental act and every deed there is a 
decomposition or molecular change in some of the 
brain cells, followed by rapid repair; but this repair^ 
is not an exact reproduction of the brain tissue, — a 
modification is produced in its substance, the character 
of the modification depending upon the quality of the 
thought or act performed; that is, if any given act or 
deed is good, that modification which takes place in 
the reproduction of the brain tissue is such that this^ 
same portion of the brain will, in the future, more 
easily generate thoughts and deeds of even a higher 
standard. On the other hand, if any given thought or 
deed is evil, the modification which takes place is of 
a different character, and in this case we have brain 
tissue which, should occasion arise, is more likely 
than before to generate thoughts of a low» standard. 
Thoughts and deeds of a good or evil character are- 
produced by education and environment, being, of 
course, modified to a great extent by hereditary in- 
fluences; and it is in this way that proper education 
and surroundings elevate the functions of the brain, 
so that it will generate thoughts and deeds far nobler, 
less selfish, and more moral than it was wont. 

The object of all law is to protect society and to 
prevent crime. It is the criminal we should consider, 
and not the crime alone, — ^the crime is merely one symp- 
tom of a defective organization. No two criminals are, 
perhaps, exactly similar, hence each class should be 
dealt with differently. Each criminal should be exam- 
ined just as we diagnose disease, observing his heredity, 
physical and psychological characteristics, and his en- 
vironments, taking a complete clinical history of him,- 
so far as possible; whether congenital or acquired, 
whether capable or incapable of rectification and im- 
provement. * 

Prof. Ferri, in his work on "Criminal Sociology," 
makes the following classification of criminals: "1. 
Criminal madmen; 2, born criminals; 8, criminals by 
contracted habits; 4, occasional criminals; 5, criminals 
of passion." 

The class of "criminal madmen" consists of those 
who commit crimes while insane, and includes homicidal 
mania, moral insanity, and some cases of paranoia. 
They are, as a rule, hereditary, though latent until the* 



WILLIAM GLAS8BLL SOM^RVILLB. 3g$ 

periods of puberty and adolescence^ or later in life. 
These cases shade imperceptibly into the "born crimi- 
nals," who are degenerates — true moral imbeciles ; their 
moral insensibility is such that they have no self-con- 
trol against crime; their crime is a neurosis. "They 
are like a painter in his studio, dreaming of their next 
masterpiece," and are unaffected by punishment, which 
is a natural risk of their occupation, just as miners or 
those who handle dynamite do not reckon the dangers 
to which they are exposed, and are uninfluenced by 
the terrible accidents which so frequently befall their 
fellow workmen. The criminal insane and the born 
criminal are not morally responsible, inasmuch as 
they are congenrtally defective, and hence not re- 
sponsible for their degeneracy. Yet, these two classes,, 
as well as all classes of criminals, are legally responsi- 
ble, for social defense requires that they be placed 
where they cannot commit crimes, and for so long a 
period as they would be dangerous to society. The 
only question would be, where? 

The "criminal by contracted habit," as a rule, com- 
mits his first crime in youth, almost invariably against 
property, and through moral weakness, induced more 
by environment than by hereditary tendencies. These 
cases are liable to relapse, if their environments are 
unfavorable, or, if associated with hardened criminals. 
The "occasional criminal" commits crhne on account 
of his physical and social environment, and does not 
relapse, if temptations are removed. The "criminal of 
passion," as a rule, commits a crime against the per- 
son, done either in anger or in defense of honor, usually 
not premeditated, but with a precise motive, and open- 
ly, and followed by remorse. These cases rarely re- 
lapse. Prof. Perri says that **the true difference be- 
tween the bom and the occasional criminal is that, 
with the former, the external cause is less operative 
than the internal tendency, because this tendncy pos- 
sesses, as it were, a centrifugal force, driving the in- 
dividual to commit crime, whilst, for the occasional 
criminal, it is rather a case of feeble power of resist- 
ance against external causes to which most of the in- 
ducement to crime is due." And, again, he says: 
**WIth the bom criminal it is, above all, the lack or 
the weakness of moral sense, which fails to withstand 



:884 YOUTHFUL AND INSANS CRIMINALS. 

crime, whereas, with the occasional criminal the moral 
sense is almost normal, but inability to realize before- 
hand the consequences of the act, causes him to yield 
to external influences." 

In the management of youthful criminals we must 
recognize the fact that we have different types,— K)ne 
class, however, shading almost imperceptibly into the 
other; and it is evident that the treatment should not 
be the same for each class. Furthermore, the criminal 
should be considered and not the crime, for crime is 
a symptom of a condition, — ^an act, a transgression of 
the laws, by an individual, who is a degenerate, either 
insane or a moral imbecile,— or who is impelled by 
social environments, or by habit, or by passion. 

The "born criminal" we cannot hope to reform. This 
class, no matter what the crime, if it can be shown 
that they are born criminals, as indicated by their fre- 
quent relapses and defective moral sense, should be con- 
fined indefinitely and forever. They are unable to 
adapt themselves to their social environments, and 
shoud be removed. They should be kept separate from 
those who can be reformed, for there is no doubt that, 
although young, they will have a bad influence over 
other criminals. Much can be done in the way of refor- 
mation of the "criminal by contracted habit," and the 
"occasional criminal." 

When a person is placed on trial, and all evidence, 
pro and con, has been given, the duties of judge and 
and jurors should cease, when the latter have rendered 
their decision as to the guilt of the accused. If the 
person has been found guilty, the verdict in all cases 
should be "to be conflned until reformed." What good 
is accomplished by sending a prisoner up for thirty 
days, or to the penitentiary for three months, as is 
often done? The young man and the occasional crimi- 
nal come in contact with the habitual criminal, and 
there can be no question as to the result. They are 
turned loose upon society more degraded, morally, 
more hardened, and more adept in crime, than when ad- 
mitted ; perhaps, to again fall into crime. 

All transgressors against the law should be given inde- 
terminate sentences; and, as far as possible, classi- 
fied according to their moral responsibilities. Every 
one should be compelled to work, and receive instruc- 



WILLIAM 0LA88ELL 80MERVILLE. 355 

don in branches of literature or rudiments of learn- 
ing, and in ethics, philosophy, and physical culture, 
according to his requirements and natural ability. 
The duration of his confinement should depend on his 
moral character, and disposition to work. When the 
authorities of the institution, who must be competent 
judges, decide that any one is entitled to a release, 
such person could be given a parole, and required to 
report by letter to the authorities at specified inter- 
vals. Any violation of parole should, without trial, 
subject him to further incarceration. The Elmira Re- 
formatory, in New York State, which was opened in 
1876, has practically this system. What are the re- 
sults? Eighty per cent, never relapse into crime, and 
the average time of detention is twenty-two months. 

The question of unfixed or indeterminate sentences 
is thoroughly practical and scientifically correct, for 
adult, as well as for youthful and insane, criminals; 
for, as Villert says: "When the measure of punish- 
ment is fixed beforehand, the judge is like a doctor, 
who, after a superficial diagnosis, orders a draught for 
the patient, and names the day when he shall be sent 
out of the hospital, without regard to the state of 
his health at the time." For economic reasons, also, 
the indefinite sentence is preferable. In New York 
State it is estimated that the average detention of the 
inmates of the Reformatory, where there is an indeter- 
minate sentence, is twenty-two months; whereas, for 
those committed to the penitentiary for the same crimes 
and for fixed periods, the average imprisonment is five 
years, — the former being an immense saving to the 
State. 

A penal agricultural colony, for the detention of 
certain classes of young criminals, is one of the best 
methods for social defense, as well as a means for their 
reformation and change of environments. Outdoor 
labor tends to secure physical and moral health, and 
every degree of labor, from light to severe occupation, 
can be obtained. This method would be specially ap- 
plicable to those who have committed their first offense 
and are not too defective, morally. It would avoid the 
bringing together of all classes of criminals, where, 
through contagion, many of the most promising ones 



388 YOUTHFUL JjfD INSANE CRIMINALS, 

are bound to be made worde by astociation with tM 
bom and inedrrigible criminal. 

For some offenseB, such as bodily iitjuryy blows, 
threats, and slander, committed by criminals of passion^ 
or occasional criminals, (the former of which are not 
criminals in the strict sense of the word,) there shonld 
be a reparation of damages by fines, deduction of 
wages, or forced labor. This reparation of damages 
should be made a penal substitute, — ^to obtain which it 
should be unnecessary to enter the civil coul^. 

As there is no distinct line of demarcation between 
sanity and insanity, so the type of some criminals 
merges into that of the insane madman. As Maudsley 
expresses it, ^'there is a borderland between crime and 
insanity, near one boundary of which we meet with 
something of madness, but more of sin, and n^ar the 
other boundary of which something of sin, but more of 
madness. A just estimate of the moral responsibility 
of the unhappy people inhabiting this borderland will 
assuredly not be made until we get rid of the metaphys- 
ical measures of responsibility, and proceed by way 
of observation and induction to sound generalizations 
concerning the origin of the moral sentiments, the laws 
of their development, and the causes, course, and va- 
rieties of moral degeneracy." 

In the class of criminal madmen, we would call spe- 
cial attentian to paranoia^ which is defined by Pi^)f. M. 
Allen Starr as ^^a chronic fortn of delusional insanity, 
characterized by fixed and syistematized delusions, 
which dominate, but do not impair, the intellect The 
majority of the doubtful cases of the criminal insane 
are paranoiacs. Guiteau is an example of this unfor- 
tunate class, whose legal murder is a blot upon science, 
as well as upon humanity. 

We are of the opinion that the criminal insane 
should be confined in separate asylums, on account of 
the demoralisation which this class exerts ovfer the 
harmless insane; and, because being dangerous, they 
should be more securely confined; for, it is a fact that 
the ordinary insane hospital is not sufficiently secure 
for the confinement of many insane criminals, toie 
management and discipline of the **criininal madman,^ 
furthermore, is necessarily different frofaa that of th^ 
harmless insane. We believe, too, that the cHtninal 



WILLIAM aLASSBLL SOMERVILLE. 367 

lunatie a8ylum> is the place fbr those unfoirtuiiate de* 
generates who inhabit the "borderland^' between crime 
and insanity. Whether sane or insane, if dangerous to 
society, social defense demands that they be confined^ 
The criminal insane asylum will prevent the hue and 
cry which is raised whenever a criminal is "acquitted 
on the plea of insanity." There should be no acquit- 
tal ; — ^if he is insane^ or if he has no moral sense, no 
matter how slight the crime, and if he is dangerous to 
society, and he is, he should be confined until he has 
recovered, or is no longer dangerous, which, in many 
cases, would be for life. This class of cases needs car* 
ing for more than the harmless insane. 

There is another class of evil doers, who are no more 
responsible tor their condition than they are for the 
color of their hair, or shape of their noses, or than the 
lunatic is responsible for his insanity. I refer to the 
dipsomaniac or the periodical drinker. This condition 
is an inherited disease, — a neurosis. The father, or 
mother, or some ancestor, was neurotic, or insane, or 
a drunkard. It is his inheritance, his birth-right. If 
he had not been an inebriate he might have been in- 
sane, or a criminal. If he had been insane, we would 
confine him in a lunatic asylum ; if a criminal, he would 
he sent to the penitentiary. But if, perchance, ineb- 
riety is his inheritance, we do nothing either to protect 
him or society, unless he infringes upon the majesty 
of the law, and then he is treated as anv other crim- 
innl. There is great need of legislation along this line. 
The physician, or family, should be enabled to control 
the cases legally. Moral, social, and religious, in- 
fluences, and detention, where they cannot obtain alco- 
hol, do more to cure these cases than medicine. The 
State, in order to care for chronic alcoholics, might 
tax the saloons enough above the present rate of taxa- 
tion. There is need, also, to provide, by legislative 
enactment, for the care and supervision of the children 
of criminal and drunken parents, as their environment 
ft-om infancy is such that when they have reached ma- 
turity they are too frequently hardened criminals. 
There is no doubt, also, that the publication of the de- 
tails of murder by the press is, by suggestion, a great 
source of crime, and should be restricted by law. 

The points which I wish to emphasize cannot be bet- 



388 YOUTHFUL AND INSANE, CRIMINALS. 

tep expressed than in the words of Mr. Arthur Mac- 
Donald, in his work on "Criminology:" ^^First — It is 
detrimental, financially, as well as socially and moral- 
ly, to release prisoners when there is a probability of 
their returning to crime; for, in this case, the convict 
is less expensive than the ex-convict. 

^^ Second — The determinate sentence permits many 
prisoners to be released, who are morally certain to 
return to crime. The indeterminate sentence is the 
best method of affording the prisoner an opjwrtunity 
to reform, without exposing society to unnecessary 
dangers. 

^^Third — The ground for the imprisonment of the 
criminal is, first of all, because he is dangerous to so- 
ciety. This principle avoids the uncertainty that may 
rest upon the decision as to the degree of freedom ; for, 
upon the last principle some of the most brutal crimes 
would receive a light punishment." 

Whatever be the remedy for crime, the causes must 
first be studied; and, let us, as physicians, put our 
shoulders to the wheel, and by virtue of our knowledge 
of the laws of heredity, and by virtue of our studies of 
the physical and psychological state of the criminal, 
and by virtue of our knowledge of the degrees of respon- 
sibility, obtain just and scientific laws for the manage- 
ment and betterment of these unfortunate people. Let 
us study these causes, and the prevention of crime, in 
a philosophical manner, that the destiny of future gene- 
rations may be favorably influenced. 

DISCUSSION. 

Dr. R. M. Cunningham — There is, perhaps, no more 
important subject than the one introduced by this paper. 
We must not forget the fact that this Association is 
the State Board of Health, and that it is our duty to 
recommend legislation. Were it not for the discourage- 
ment we have met with in the last two Legislatures, I 
feel that this subject should be taken up by the Asso- 
ciation and something definite formulated thereon. The 
public has no more idea what crime is than it has of 
the abstract principles of creiition. The general public 
holds that crime is the outgrowth of old Adam, and 
that the criminal could wholly control himself. The 
popular idea is that crime is sin, pure and simple ; that 



DISCUSSION. 38a 

it is wholly volnntary, and can be controlled by the in-» 
dividual himself, — hence it is that the object of crimin* 
al administration is to punish. The doctor made a 
statement that ^^he destiny of man was fixed by his 
ancestry." That is a very serious thing, and, if true^ 
man and woman can assume no greater responsibility 
than when they become parents. I believe that if peo^ 
pie would apply the same sense to the cultivation of 
children that the planter applies to the raising of crops' 
and of stock, the time would come when insanity, im- 
becility and idiocy would be things of the past. If the 
conception of the doctor's paper is right, then, I say, 
that the execution of law, as it is done today, is a dis- 
grace. The primary principle in the execution of law, 
as it is now found, is more for the purpose of enriching 
the counties and State, and filling the pockets of offi- 
cers with fees, than to teach wholesome lessons and put 
a stop to crime. 

Tou cannot reach the lawmakers on this great ques- 
tion, and we will have to begin at the cradle. It should 
be taught to the children in the public schools. I have 
long since believed that nobody deserves any particu- 
lar credit for being honest. It is a heritage which he 
must obey. Ancestors and environments & our desti- 
nies. I thank the doctor for his valuable paper. 

Dr. H. A. Moody. — In connection with this subject^ 
I desire to raise a question that has engaged my atten- 
tion for some time. The queston is this: Have we a 
right to punish a man for a crime which he inherited 
from his parents? It is right for us to consider what 
is just, and what is unjust. I have seen some practical 
illustrations along this line. I know a good woman in 
the city of Boston, who has made a thorough study of 
sociology, and the result of her study is that she thinks 
more of a criminal than of an honest man. There ia 
danger in our acknowledging that a man is not respon* 
sible for the crime he commits, and, although there is 
an essence of truth in the statement, yet, if carried out^ 
to its logical conclusion, it would lead to mischief. 
Think for a moment, what would have been Quiteau'sf 
destiny if the question of heredity had been taken into 
consideration? He would never have died as he did,* 
but would have been confined in some flower-laden cell. 



fgO THE PRONATED FOOT. . 

where his sjmpathisers could have daily yisited him. I 
think it well to look at both sides of tiie question before 
forming our opinions. 

Dr. T. D. Parke. — ^I only want to thank Dr. Sommer- 
yille for this excellent paper, and to say that we ought 
to be educated to the proper conception of criminals 
and their treatment What a man thinks, and what he 
does, is due to his ancestry, and to his environment. 
If a criminal cannot be cured, then, keep him in con- 
finement. So long as our criminal processes are radi- 
callj wrong, and so long as our officials are making 
money out of them, just so long will our coal mines be 
filled. 



THE PRONATED FOOT. 



Bt Michael Hoke, M. D., AruLirTA, Oa. 



From a mechanical point of view, the foot is 
the most splendid piece of anatomical structure in the 
human body, in spite of the fact that the dress customs 
of civilization have shown little regard for its needs, 
if its strength is to be considered a desirable thing. The 
relation of its bones, its ligamentous braces, its muscu- 
lar suspension, together, make up a series of flexible, 
elastic, arches, which, for precision of design, can find 
no counterpart in nature. 

Its function is to support the body weight, and, as a 
lever, to make locomotion a movement of poise, activity, 
and grace, free from all pain. 

Its attitudes, its ranges of motion, controlled and bal- 
anced by its muscles and the muscles of the leg, the 
fashion of its covering, the manner of its use, are all 
factors in the preservation of its integrity, as an effi- 
cient and lastingly useful piece of mechanism. 

Like all complicated pieces of mechanism, its com- 



UIOHASL BOKB. ^l 

pooent parte must be ia a normal condition, the mascu^ 
lar power must be sufficient, and it must be properly 
used, if it is to be serviceable. 

. If any of these conditions is lacking, the foot is no 
longer elffective as a lever, ite spring is lost, the mus- 
cles which control ite balance act in a faulty manner, 
and no longer distribute the body weight so that the 
foot, as a unit, bears it ; the attitude of passive support 
is assumed; it yields, the foot is weakened, pain, awk- 
wardness, and disability follow. 

The type of non-deformed, but structurally weaken- 
ed, feet are many, indeed, each foot has its own structur- 
al individuality, thus, nearly all cases falling under a 
type of defect, present individual problems for solation. 
But each type, having ite own definite, dynamical, 
forces which produce the defect, has its own general 
principles, to be followed as a basis for treatment in- 
i^ided to correct the defect and relieve the symptoms* 

I have elected to speak of the pronated foot. 

It is the most common type of the weakened, non- 
deformed, foot, — producing pain that exists without 
<!hange in the bones of the tarsus and metatarsus. The 
proaatiag force is active in the production of flat-foot, 
difficult there to overcome, hence of interest. It pre- 
sente, too, one of the most interesting problems in that 
I)art of orthopedic surgery concern^ with the appli- 
cation of apparatus for the correction of a faulty ana- 
tomical position, attended by disability. I have se- 
lected it, also, because this vicious position plays an 
important and sometimes dramatic part in the relief 
of symptoms in feet, ankles, knees, and hips that, hav- 
ing passed through a severe acute or chronic arthritis 
^f any nature, are painful, not from disease still exist- 
ent, but from the fact tboA the relation of the bones 
forming the joints has been so altered that the leg 
trassQiits the body weight, and the feet sustain it, in 
a manner productive of joint strain. 

I shall confine myself as briefly and strictly as pos- 
sible to those anatomical, dynamical, and mechanical 
principles concerned in permitting and correcting the 
tveuUe. 

The clinical importance will be shown by the report 
of a few typical cases. It is necessary, first, to picture 
ihe best type of foot. The position of strength is thf^t 



f90 ^^^ PRONATED FOOT. . 

where his sympathisera could have daily visited him. I 
think it well to look at both sides of the question before 
forming our opinions. 

Dr. T. D. Parka — ^I only want to thank Dr. Bommer- 
ville for this excellent paper, and to say that we ought 
to be educated to the proper conception of criminals 
and their treatment What a man thinks, and what he 
does, is due to his ancestry, and to his environment. 
If a criminal cannot be cured, then, keep him in con- 
finement. So long as our criminal processes are radi- 
oallj wrong, and so long as our officials are making 
money out of them, just so long will our coal mines be 
filled. 



THE PRONATED FOOT. 



Bt Michael Hoke, M. D., Axlaivta, Qa. 



From a mechanical point of view, the foot is 
the most splendid piece of anatomical structure in the 
human body, in spite of the fact that the dress customs 
of civilization have shown little regard for its needs, 
if its strength is to be considered a desirable thing. The 
relation of its bones, its ligamentous braces, its muscu- 
lar suspension, together, make up a series of flexible, 
elastic, arches, which, for precision of design, can find 
no counterpart in nature. 

Its function is to support the body weight, and, as a 
lever, to make locomotion a movement of poise, activity, 
and grace, free from all pain. 

Its attitudes, its ranges of motion, controlled and bal- 
anced by its muscles and the muscles of the leg, the 
fashion of its covering, the manner of its use, are all 
factors in the preservation of its integrity, as an effi- 
cient and lastingly useful piece of mechanism. 

Like all complicated pieces of mechanism, its com- 



MICHAEL EOKE. 391 

pooent parte must be Ih a noraial condition, the mascu* 
lar power must be sufficient, and it most be properly 
4ised, if it is to be serviceable. 

If any of these conditions is lacking, the foot is no 
^]onger effective as a lever, ito spring is lost, the mus- 
cles which control ito balance act in a faulty manner, 
and no longer distribute the body weight so that the 
foot, as a unit, bears it ; the attitude of passive support 
is assumed; it yields, the foot is weakened, pain, awk- 
wardness, and disability follow. 

The type of non-deformed, but structurally weaken- 
ed, feet are many, indeed, each foot has its own structur- 
al individuality, thus, nearly all cases falling under a 
type of defect, present individual problems for solution. 
But each type, having ito own definite, dynamical, 
forces which produce the defect, has its own general 
principles, to be followed as a basis for treatment in- 
tended to correct the defect and relieve the symptoms. 

I have elected to speak of the pronated foot. 

It is the most common type of the weakened, non- 
deformed, foot, — producing pain that exists without 
<!hange in the bones of the tarsus and metatarsus. The 
proaating force is active in the production of flat-foot, 
difficult there to overcome, hence of interest. It pre- 
«i^ite, too, one of the most interesting problems in that 
part of orthopedic surgery concerned with the appli- 
cation of apparatus for the correction of a faulty ana- 
tomical positi(m, attended by disability. I have se- 
lected it, also, because this vicious position plays an 
important and sometimes dramatic part in the relief 
of symptoms in feet, ankles, knees, and hips that, hav- 
ing passed through a severe acute or chronic arthritis 
«rf any nature, are painful, not from disease still exist- 
ent, but from the fact that the relation of the bones 
forming the jointo has been so altered that the leg 
traAs^lits the body wd§^t, and the feet sustain it, in 
a manner productive of joint strain. 

I shall confine myself as briefly and strictly as pos- 
sible to those anatomical, dynamical, and mechanical 
principles concerned in permitting and correcting the 
4J5enbie. 

The clinical importance will be shown by the report 
of a few typical cases. It is necessary, first, to picture 
ihe best type of foot. The position of strength is thiM: 



392 ^^^ PRONATED FOOT. 

position in which the foot acts most effectively as a 
lever; the position of weakness, whether unconscionslj 
assumed or forced on the foot by some of the many im* 
IK)sitions possible, is that position in which the foot, 
as an anatomical lever, is placed at a disadvantage to 
do its work. All of these attitudes are simply ezpres* 
sions of how the body weight is borne. 

Von Myers' rule formulates the accepted ideas aB to 
the proper relation in position of the foot to the leg: 
"The line of the crest of the tibia, if prolonged down- 
ward, should pass over the dorsum of the foot to the 
cleft between the second and third toes, the inner bor^ 
der of the great toe, the inner malleolus and the inner 
condyle of the femur being in the same plane." 

This agrees with the best type of nature. 

The foot of an infant shows unimpaired muscular 
power in the movement of all of the toes. The great 
toe can be voluntarily adducted, the fifth abducted, 
all can be markedly flexed. There is a space between 
the great and second toes. The toes are straight The 
infant adducts frequently the great toe, demonstrating 
great freedom of its motion. The line of the extremi* 
ties of the toes forms a curve, with the greatest point 
of convexity at the end of the second toe. The line of 
the heads of the metatarsals present the same curve; 
The line of the inner edge of the foot is apparently 
straight. Though small, it is a perfect miniature of 
the strong foot, its toes straight, its motion free. Young 
children, in beginning to walk, always place the feet 
with their axes parallel, or with a slight toeing in. 

The inner edge of the adult feet that have not worn 
shoes, nearly always appears straight; the great meta- 
tarsal bones are comparatively greatly developed; the 
prehensile strength increasing with age up to a cer- 
tain limit. 

Barbaric models and Egyptian sculptures, types of 
the barefooted and sandal-wearing people, are char^ 
acterized by the parallel relation of the axes of the feet 
in the standing position, by the straight inner edge ot 
the foot and straight toes. The early Indian, Burmese, 
and Egyptian art, show this to be true, and the classic*^ 
al type of sculptures represent the line of the inner 
edge of the foot as always straight with an extremely 
small angle of divergence of the axes of the feet in the 



MICHAEL HOKE. 39^ 

Standing position. This is true of the Greek and Bo- 
man art.. 

Individuals who have never worn shoes, walk with* 
the feet directed almost straight in front. The mocca- 
sin-wearing and barefooted races of to-day, with whom 
foot activity plays an important part in obtaining a 
livelihood, either slightly toe in or walk straight. The 
mnscles of the front part of the foot are strongly de- 
veloped. If the gait of an athlete be observed, it is 
seen that the feet are advanced in a straight line, or 
with a very slight angle of divergence. It is interest- 
ing here to note that the talii)es eqninus deformity,, 
with the front part of the food adducted, is the strong 
type. Individuals possessing this deformity move 
actively, though awkwardly. Contrast this with the- 
slow, halting, rolling, weak gait of the valgus type of 
deformity, with the foot abducted. As shown, then, by 
the bare-footed and sandal-wearing races of antiquity, 
and, to-day, by those who are active, with strong mus- 
cles in the legs and intact feet, the position of strength 
is with the feet parallel, that is, with the front part of 
the foot adducted, the inner edge of the foot straight, 
apparently with great prehensile strength. I wish you 
to bear this in mind; it has its clinical significance, 
and is to be contrasts! with the weakened position to 
be described. The reasons that this supinated position 
is the position of strength, are as follows: 

The foot has two antero-posterior arches, an inner 
and an outer one. They are distinctly opposite in char- 
acter of construction, and hence in function. The- 
outer one is composed practically of only two bones, 
the OS calcis and cuboid, closely bound to one another,, 
with little play of motion between them at their ar- 
ticulation. The metatarsal of the fifth enters into the 
formation of this arch with the foot in the non-weight 
bearing position, but must be excluded from it in the 
weight-bearing position, for then throughout its whole- 
length it rests upon the ground. This arch is short, 
compactly built, and always rigid. The inner arch, 
twice as long, with five bones entering into its forma- 
tion, 06 calcis, astragalus, scaphoid, cuneiform, and 
first matatarsal, with several muscles attached to it, 
fiexible, possessing a wide range of motion compared 
to the outer, is constructed not for passive weight bear^ 



9M THS FBOJUATKD rOOT. 

ixxgy bat to sugtaio a great and sudden Bhock, witboat 
jar, to yield slightly^ and to rebound to its forn&er posi- 
tUyu in tbe fln^ spring given to the completion of the 
step. It is this arch, and its attached muscles^ that 
make the gait active and springy. The outer arch is 
built, then, to stand paasive weight-bearing all the 
time, as in standing, and very seldom does it ever 
yield. The inner arch should bear the weight only 
momentarily in the completion of the step in walking, 
a^nd quickly shift the body weight outwards, to be 
borne again by the other arch as soon as the foot 
is placed on the ground. This can be demonstrated: 
Make yourself conscious of pressure on the sole of the 
foot in standing, with the foot in the supinated posi- 
tion, axes par^lely front part of the foot adducted. 
You feel the pressure under the heel and outer portion 
of the foot, and beneath the heads of the fifth, fourth, 
third, and, to a lesser extent, the second metatarsal. 
You are conscious, in this position, of very little prea- 
aure under the head of the great metatarsal. It is no^ 
felt there to any extent until the heel is raised in tak:- 
ing a step. More convincing it is, to place an individual 
on a glass table in the standing position, with the foot 
in the strong position, supinated as before described, 
the axes parallel, so that Von Meyer's line may be 
drawn. Then the dead white area of pressure, if you 
look at the under surface of the foot through the glass, 
is seen to extend over the heel, and from the fifth meta- 
tarsal into the second, as above mentioned. This is the 
strong position, for when it is assumed, the body weight 
is borne by the strong, inflexible, unyielding, outer 
areh, the inner arch bearing very little of it. 

When, oil the contrary, the weight is borne on the 
inner arch, sufficiently to tire out the tibiales, flexors, 
and adductors of the great toe, it yields from this pas- 
sive support to which it is not adapted in structure, 
its ligaments become stretched, and the excessively 
pronated foot, with its train of symptoms and lameness, 
results. 

This vicious position is the attitude in which, in the 
Ivabitual standing position, the foot rolls over inward, 
Instead of being supinated; the inner edge of the foot 
ahows a reverse curve, with its convexity inward, in- 
ieitead of a straight line or slight curve, with its con- 



MICBAEL BOKE. 395 

vexity outward ; the front part of tlie foot is abducted, 
instead of being addueted, and the outer edge of the 
foot rolls up, the front part of the foot being rotated 
inward^ as well as abducted. The line drawn through 
the crest of the tibia, and over the dorsum of the foot, 
representing the direction of action of the body weight, 
passes off the inner arch of the foot at the atragalo- 
scaphoid articulation, instead of at the cleft between 
the second and third toes. The dead white area of pres- 
sure seen from beneath the sole of the foot through the 
glass plate, shifts inward until the most decided points 
of pressure are beneath the heel, and the head of the 
great metatarsal. This is the result of the body weight 
being supi)orted by the weak inner arch, applied at its 
weakest portion, the astragalo-scaphoid articulation. 
The inner arch is not constructed for this kind of 
strain, and yields, with pain. Always, even in strong 
feet, in standing and walking, there is a slight down- 
ward yielding of the inner arch, which may be called 
physiological pronation. Its physiological limits can 
not be determined in degrees, for it varies in the two 
feet of an individual, still more so in different individu- 
als. The pronation, with symptoms, is the same motion 
carried further, until it produces strain, the same in 
kind, but excessive in degree. 

Lovett has analyzed the movement of the bones in 
the pronated attitude by a study of 41 X-ray plates of 
painful pronated feet. Results of his studies may be 
summed up as follows: 

(1) The appearance of the feet is as represented 
in the photograph. 

{2) The foot, as a whole, rotates beneath the astra- 
galus into the position of valgus. 

(3) The astragalus is rotated inward on a vertical 
axis, BO that its head moves inward and backward, its 
l)ody outward and forward. There is at the same time 
plantar flexion of the astragalus, by which its head 
sinks into the sole. This is the key-note of the position. 

(4) There is some outward movement of the cu- 
boid. 

(5) The front part of the foot is abducted, moving 



896 ^^^ PROVATBD FOOT. 

outward^ the tendency being for the foot to break open 
outwardly, (if I may use the term) at the astragalo- 
scaphoid articulation, as the hinge of motion. 

(6) Anterior to the astragalo-scaphoid articulation 
there is no change in the relation of the bones, the 
whole front part of the foot moving en masae. 

(7) The OS calcis rotates in a valgus position. 
The detailed mechanical and anatomical explanation 

of the strong position, and of excessive pronation, is 
best seen by examination of a skeleton. Consider the 
body weight to be a force (W. Fig. i), acting down- 
ward in the direction of the axis of the shaft of the 
tibia; it is opposed by an equal force acting upward 
in the direction of the shaft of the tibia. The same is 
true with the foot in regard to the direction of the body 
weight forces acting through the axes of the small 
bones of the tarsus, and along the shafts of the meta- 
tarsal bones. The strength or weakness of the foot i» 
determined by the movement permitted the astragalus. 

The astragalus hcus no muscular attachments, it 
serves simply to transmit the force of the body weight 
from the end of the tibia to the foot, splitting it up 
into a number of components, some passing behind, 
some forward. 

In the strong position, the supinated one above de- 
scribed, the astragalus, as shown by Gtolobiewski, is 
tilted a little downward, at its outer border, so that 
most of the body weight is transmitted through it ,direct- 
ly to the OS calcis, thus the force of the body weight 
passes backward through the tuberosity of the calcis 
to the ground, and from the calcis in front to the cub- 
oid, and from thence to the fifth and fourth metatar- 
sal, the second and third metatarsal receiving their 
share of the weight through the head of the calcis, the 
outer end of the scaphoid, the middle cuneiform, and 
thence to their own shafts. Thus, very little weight 
is left, in the standing position, to be transmitted to 
the inner arch. Note here that there is no plantar 
flexion or inward rotation of the astragalus, as seen 
in the pronated foot, and that from the relation of the 
bones in the inner arch to one another and to the as- 
tragalus, it is not a difficult thing for the flexors of the 
great toe, the small toes, and the tibiales, to bear what 
weight may be transmitted to the internal arch in this 



MlOHAEh HOKE, 397 

strong position^ the result of that little weight being 
the physiological degree of pronation recognized as nor- 
mal. If, on the contrary^ the front part of the foot is 
by habit held in the abducted position, so that Meyer's 
line {see illustration No. 6, the arrow) j passes off the in- 
ner arch at the astragalo-scaphoid point, the body weight 
being applied there, the tibiales and the other 
muscles attached to the inner arch become tired, 
And the astragalus is allowed to rotate inw^ards. 
Then, most of the body weight is applied to the inner 
arch. This is the pronating force. The astragalus 
splits it up into two compartments, one of these (t 
Fig. /), acts downward, and falls chiefly upon the in- 
ner half of the os calcis and the suscentaculum tali. 
The only direct opposition it has is from the tendons 
of the muscle, which pass beneath the suscentaculum 
tali, use it as a fulcrum for their action, lifting up the 
suscentaculum tali and preventing the calcis from ro- 
tating in a valgus position, so long as the tone of these 
muscles is normal. If these muscles are strong and 
the foot is used in the mechanically strong attitude, 
supination, {Fig. 5), they prevent pronation at this 
point from being greater than the physiological degree ; 
but, conversely, if from the assumption of the disadvan- 
tageous position, with the greater part of the body 
weight thrown on the inner arch, t is so greatly in- 
creased that the muscles are not strong enough to op- 
pose it; they play out, the weight falls upon the liga- 
ments at this point, then pain begins there, and that 
part breaks down. 

The other component x, acts downward, forward, 
and inward, in the direction of the axis of the astraga- 
lus, from behind, forward, and is applied at the inner 
end of the medio-tarsal joint at the astragalo-scaphoid 
articulation anterior to the point of support of the as- 
tragalus by the os calcis beneath. This, then, must be 
apposed by structures anterior to the end of the astraga- 
lus. The tendency of this force is to crush arch a b c d 
E p downward, forward, and inward, at d; to convert 
arch a' b' c' d' f' into a" b" c'' d'' f'' ; to roll the foot in- 
ward, as shown in the photograph ; to abduct the front 
part of the foot, and at the same time to rotate a b c d 
in a valgus position, assisted by the peroneus longus, 



398 ^^^ PEONATBD FOOT. 

wfaich, attached to the baae of the great metatan&l^ 
pulte the forward column of the arch outward at s. 
This force, then, produces all of the clinical signs of 
the pronated position, except the valgus rotation of 
the OB calcis. Acting forward, inward, and downward^ 
this pronating force mo«t be opposed by an equal force 
acting upward, backward, and outward at D. It is 
seen that flexion of A B increases and strengthens 
this arch; also, that adduction strengthens arch a' bT 
c' d' b'. This is accomplished by the flexor brevis 
and longUB pollicis, and by the adductor poUicis. Muck 
more flexion than adduction is possible in the normal 
foot, consequently, to permit no more than the physio^ 
logical limit of pronation, the foot must depend chiefly- 
upon the flexors of the great and small toes. The rear 
son why flexion of the great metatarsal in Hbe supinated 
position overcomes the inward yielding at d, thus pre* 
venting excessive pronation, is due to certain anatomic^ 
al bony land-marks, of whose importance the anatomic* 
al books do not speak; to the relative position of the 
small tuberosity on the posterior end of the great 
metatarsal; to the tuberosity of the internal cunei- 
form, its whole lower border, and this tuberosity to^ 
that of the scaphoid, as represented by the shaded, 
areas. The tuberosity of the great metatarsal faces 
downward, the tuberous border of the iptemal cunei* 
form faces downward at its articulation, with the great 
metatarsal then inclined upward and inward. The 
tuberosity of the scaphoid faces inward, so that, when 
the great metatarsal is flexed by its muscles, attached 
to A, the thrust of its little tuberosity by the time its 
effect is transmitted through the internal cuneiform 
and scaphoid against the astragalus is not to lift the 
latter upward, but upward, backward, and outward, in 
direct opposition to the direction of the pronating 
forces X. Thus, by this relation, flexion of the great 
metatarsal accomplished what, without this relation 
of the tuberosities, would necessitate the position a' 
b', to be changed to a"" and b"". It is thus seen how the 
prehensile power of the great toe, meaning the XK)wer of 
the flexor longtts and brevis and the adductor pollicis, 
assisted by the tibial muscles, prevents the pronated 
position, sustains the body weight temponarily, but 
must give out, if subjected to constant strain. In the- 



MtCMAEL SOKE. ^^ 

majoiltj of cases presekitiiig tbemselres for treatment 
(til aetouttt of pain, the weak attittidey with the front 
part of the foot abducted, was first asstimed uncon^ 
Bcionsly, or forced upon the foot, by using bad shoee^ 
From contintions use of the foot in this positiok!, the 
prehensile muscle^ acting at a disadrantage, the inner- 
arch bearing the body weight, gave way witti ligamen'^ 
tons stretching. In those cases secondary to acute or 
chronic disease ih the ankle, knee, and hip, the abducted 
attitude was assumed because that is the position in 
which one may walk with greatest comfort, with disease 
of the ankle, knee, and hip. The reason of this is : The 
body weight falls entirely on the heel, and the 
patient unconsciously shifts it there by the attitude, to 
keep from bending the diseased ankle, knee, or hip. 
Later, the attitude becomes permanent, partly from habit 
and partly form a changed rela^tion of the bones forming 
the joints mentioned. The jMHKiuction of joint strain is 
due to the unstable foot basis in the pronated attitude. 
To present the clinical side of the condition, which may, 
perhaps, alone be interesting to you, I submit a report of 
the folowing cases. The details of these cases will pre^ 
sent the symptoms, physical findings, method of examina* 
tion, and treatment: 

Mrs. B. — Several years ago increased rapidly in 
weight, gaining about 40 pounds in nine months; took 
very little exercise; led an apathetic life. The first 
thing noticed was great weariness from little exertion, 
then both feet began to hurt, the pain being located ait 
the inner ahd outer sides of the ankle, at the attachment 
of the posterior tibial to the BCaphoid, and along the 
course of the tendon of the peroneus longus, as it 
winds across the outer surface of the os calcis. At 
night the knees and otrter portion of the calf of the 
leg ached a great deal ; this continued for about a year ; 
she Was able to get around, of course. It was thought 
that she had rheumHtic gout. Both feet were pronated, 
the toes turned out, the ankle rolled in, Myer*te line pass- 
ed off the Internal arch at the astragalo-scaphoid articu- 
lation; dorsal and plantar dexion were possible to a 
hormal limit; voluntary adduction was limited, the ef- 
tert feeble; th^re Was no fiattening of the arch; th* 
peronetts longtra was in a i^te of spasm, adduction ^pfo- 



400 ^^^ PRONATED FOOT. 

"dacing pain; a foot plate was applied^ the highest lift 
of the plate being carried forward to the inner cunei- 
form. The tarsal pain was instantly relieved. The 
knee pain and aching in the leg disappeared in about 
a month after the application and constant use of the 
foot plate. The relation of the pronated foot to the 
pain in the knee and calf of the leg is definite, clinic- 
alljy and can be anatomically and mechanically ex- 
plained with perfect accuracy, but its demonstration is 
complicated and tedious, hence, I simply refer to it 
She will have to wear the plates all the time. This case 
and the one following illustrate the most common type 
of the trouble. 

Case 2. — Mrs. Q. — Complained that she could not 
walk further than a few blocks without giving out; in 
church, she had to stand first on one foot, then on the 
other; had pain at the instep in both feet and back- 
ache ; there was no knee pain ; the feet were pronated, but 
perfectly mobile; the ranges of motion, both voluntary 
and passive, were normal; there was no spasm; plates 
were applied ; she can now, by using the foot plates, walk 
four or five miles with only that degree of weariness to be 
expected from this amount of exercise by a woman. She 
has to wear the plates only when walking a great deal. 
Here, the interesting point was the relief of the pain 
in the back ; its explanation is anatomical and mechanic- 
al, too, but can only be demonstrated by a complicat- 
ed examination of the relation of the angles of the 
medio- tarsal ankle, knee, and hip joint; it may be 
passed over for the sake of brevity by the statement 
that the position of pronation so acts that the back 
muscles are tired out to the point of aching with com- 
paratively little exertion. 

Case 3. — Mr. S. — The photograph was taken of this 
case; his business kept him on his feet all day. At 
the time he was seen there was very great pain in the 
instep, at both sides and behind the ankle; in the heel, 
and at the attachment of the plantar fascia, and of 
the tendo-Achilles. The ankle was puffed, behind, 
there was a good deal of pain across the ball of the 
foot, and just external to the attachment of the patella 
tendon; the patient walked with great pain, without 
rising upon the toes ; with knees fiexed, feet wide apart. 




Figf, 1. Right foot, inner longitudinal arch. X and Y— components 
of body weight falling on inner arch tending to pronate the foot; Y is 
resisted by tendons (arrow) passing beneath suscentaoulum tali, E; 
Y produces valgus rotation of oscalcis; X, the abduction of the front 
part of the foot. 




Fig. 2. Skeleton of foot viewed from above. X tends to reverse 
arch A' IV C D' F' making it A'" B'" C" D'" F'" seen in Fig. 3, or the 
character of this arch in the pronated foot. 




Fig. 3. 

Inner row of bones of 
pronated foot. Note that 
A'" etc. ia the reverse of 
A' etc. 



\^ 



\ 



'\ 



Fig. 5. 

Supinftted 
or strong po- 
sition. 



Vu. 



/ 



/ 



Fig. 4. 

Ltnder surface of inner row of bones, right foot. Shaded lines«« 
tuberosities. Small arrows show how flexion of the great metatarsal, 
when its impulse along the tuberosities reaches D, is equivalent to a 
force acting directly opposite the line of action of X. 



/ 



r 

/ 



• ■• 



i 



Fig. 6. 

!. — Note the prominencp of A. the abduction of the 
front part of the foot. The arrow Indicates the lino 
of action of the body weight. 



Fifir- 7. 

The steel foot plate made on a carved Plaster of ParU cant of 
the loot is riveted between two piecea of leather, it is slipped in 
the shoe like an insole. 



MIOHABL HOKE. 401 

seeking a broad base of support^ like the gitit of a 
feeble old man; all the motions of the feet were pain- 
ful; dorsal flexion was limited by the spasm of the 
soleus; voluntary adduction was almost impossible; 
the tibial muscles being almost paralyzed by the strain 
they had borne ; there was spasm of the peroneus long- 
us, which, with no opposition on the part of the tibial 
muscles, held the front part of the foot in abduction. 
This represents the severest type of what one might 
term, acute prong-ted foot, approaching flat foot in its 
anatomical defects, with all the symptoms of that con- 
dition. Plates were applied, all the muscles of the feet, 
leg and thigh had to be gradually reeducated to take 
up their proportionate share in sustaining and propel- 
ling the body ; he was put to bed ; given massage, elec- 
tricity, and exercised every hour and a half, going 
back to bed immediately after the exercises, in order to 
relieve the foot of passive weight bearing; the feet 
were put through the normal motions twice daily, re- 
covery was, necessarily, gradual. After two months' 
treatment he was able to return to his business*; at 
present the right foot is perfectly sound; he does not 
wear a plate in the right shoe; there is no pain in the 
knees; the left foot is a little painful where the per- 
oneal tendon winds around the cuboid if the plate is 
not worn in the left shoe, but with the plate in the left 
shoe there is no pain; this left peroneus longus is still 
somewhat spastic; the spasm will dsappear when the 
voluntary adduction becomes a little stronger. His 
manner of walking now shows nothing wrong, except 
that it is not quite as active as it should be. In a 
little while he will regain entirely his normal strength 
and activity. 

Case 4. — The effect of the pronated foot in this case 
was quite dramatic ; the patient gave a history of having 
had a sever boil on the right patella in 1889; this 
followed an injury; the history of this suggested a 
suppurating pre-patellar bursitis; it discharged for 
about six weeks; examination of the site of this ab- 
scess did not suggest that there was originally any 
bone disease. The knee, at the time of the trouble, was 
bandaged, a posterior splint, extending from the but- 
tock to the ankle, was applied. It was thought that 
there was a connection between the abscess, the patel- 

26 



402 MORTALITY IN OUR PRIBON POPULATION. 

la, and the joint. After the place had healed, the joint 
TV'as immobilized for about eight weeks; the pain ceased 
after the healing, and the muscles of the leg had atro- 
phied from disuse. At the end of this period, fourteen 
weeks after the beginning of the trouble, he started 
to work, clerking in a store, standing on the leg all 
day; the pain in the knee joint immediately returned, 
it was the same, but from a different cause now; 
though the attention of the patient, and that of the at- 
tending physician, was centered upon the idea that 
there was still a disease in the knee joint. He had be- 
gun to use the leg, with the foot in the pronated posi- 
tion, and this was the cause of the knee pain; there 
was some pain, too, though little, in the ankle. He was 
advised not to use the leg much, and since 1889, had 
walked with a crutch and cane. He presented himself 
for treatment last October; the motions of the knee, 
hip, and ankle, were perfectly normal; the leg was 
atrophied and flabby, the foot was pronated. This was 
the whole trouble; a foot splint was applied to proper- 
ly support the foot ; the knee and ankle were bandaged 
with flannel bandages, to give some support to them; 
the' leg was massaged ; the cane was at once discarded ; 
he was put on exercise and tonics, the exercise being 
gradually increased. In six weeks, the crutch also was 
discarded; the patient walked with perfect comfort, 
and in a natural gait. 



MORTALITY IN OUR PRISON POPULATION. 



Bt Judson Davib, M. D., Cowikee, Ala. 
Member of the American Medical Association. 
Member of the Medical Association of the State of Alabama. 
Bx-8tate Physician -Inspector of (Convicts. 



In considering this subject I shall eliminate any ques- 
tion of mortality occurring in our jails. Also the bad 
physical condition of many of the convicts when re- 
ceived into our penitentiaries, which is attributable to 
confinement in our jails. 



JUDBON DAVIB. 403 

I do this, because a little study of the subject con- 
vinces me that our penitentiaries discharge many more 
convicts in bad physical condition, directly attributable 
to the rigors of penal servitude, and who die therefrom 
in the outside world, than those who die in jails, and 
those received in bad physical condition from jails, at- 
tributable to confinement therein. Hence, I will con- 
sider only the mortality of our penitentiaries proper. 

Our convicts are divided into two classes, to- wit : 

First, State convicts, or those who have been con- 
victed of graver offenses, termed felonies, and who are 
sentenced to hard labor for the State. 

Second, county convicts, or those who are convicted 
of minor offenses, termed misdemeanors, and who are 
sentenced to hard labor for the different counties in 
which they are convicted. 

The great bulk of our convicts, both State and coun- 
ty, are hired to coal mining contractors, chiefly in Jef- 
ferson county. It is estimated that about two-thirds of 
all the convicts, both State and county, are kept in two 
places in said county of Jefferson. 

In the discussion of this subject, I submit, in the 
first place, that the death-rate in our prison population 
is large — excessive — ^and beyond the limits that ought 
to be tolerated by a great and civilized State, more than 
eighty years old, and occupying the position that Ala- 
bama does. 

We can gain an idea of the enormity of our prison 
death-rate only by a comparison with the death-rate in 
the State at large, and with the death-rate in the penal 
institutions of other States. 

Of course, comparison with the average death-rate 
among the people of the State at large is not altogether 
fair, because the conditions are not the same. Still, it 
serves to give an idea, and, it may be, one more nearly 
correct than might at first appear to be the case. For, 
it is a fact that all our convicts are adults, or, rather, 
oven ten years of age ; whereas, in the outside world, the 
deaths among infants and children under ten years of 
age constitute one-third of the entire mortality. 

It is also a fact that the great bulk of our convicts are 
negroes, and that the death-rate among negroes, under 
similar conditions with white people, is nearly always 
greater than among the latter. 



MORTALITr m OUR FRI80N POPULATION. 

The reports of our State Board of Health show this 
to be true here in Alabama, and we should bear it in 
mind in the consideration of this subject. 

I think it can be safely stated that the death-rate at 
large in this State is less than two per cent — ^perhaps 
not more than 1.8 per cent., or eighteen per thousand 
per annum. The rate among the white people is some 
less, and that among the negroes is some greater — ^this^ 
I think, is about the average. 

The death-rate among our State convicts for the past 
ten years (from 1890 to 1900) has been 5.6 per cent, or 
fifty-six per one thousand — ^a rate more than three times 
aa great as in the State at large. 

And for twenty-five years prior to 1890 it was, ap- 
proximately, 8.8 per cent, or eighty-eight per thousand 
— ^a rate about five times as great as in the State at large. 

These figures, among adults, appear appalling when 
we think of a rate of only eighteen per thousand in the 
State at large, including infants, and children under 
ten years of age. 

But, the Physician-Inspector of Convicts in his last 
bi-ennial report, 1898 to 1900, seems to think the situa- 
tion is growing better when he points out that "The 
average annual death rate for the past two years for 
State convicts has been 4 2-5 per cent." (forty-four per 
thousand ) , and that "The death rate for the two years 
ending August 31st, 1898 was 4 4-5 per cent." (forty- 
eight per thousand), which is lower than for any other 
four years. But it should be borne in mind that during 
the last four years, when the rate was smallest, there 
were pardoned and paroled 260 more convicts than in 
the preceding four years. 

The Physician-Inspector says that tuberculosis caused 
nearly one-half of all deaths among State convicts, and 
that this number w^ould have been larger but for the 
fact that upon his recommendation the Governor re- 
leased a number of sick convicts, a majority of whom 
were consumptives. 

So, then, to my mind, it is questionable if much, or 
any, real improvement in our prison death-rate has 
taken place. 

Who can say how many of the 260 convicts released 
in the last four years (1896 to 1900) in ewceas of the 
number released in the preceding four yearo (1892 to 



JVDBOV DAVIB. 4fi^ 

1896 )) would have died in prison if they had remained? 
There can be no question that the death-rate would, in 
that ease, have been larger than it was, for the Physician- 
Inspector says that a number of those released were 
sick, and with consumption. 

Indeed, it is a fact that there were released during 

the last four years (embraced in the Convict Reports 

from 1896 to 1900) 498 State convicts by pardon and 

X>arole, whereas, during the sixteen years preceding 

(from 1896 back to 1880) only 481 were so released. 

Of course^ we can understand that the death-rate in 
our prisons can be made very small, if only enough sick 
and feeble convicts are pardoned or paroled before they 
have time to die in prison. This is really no actual im- 
provement, for many of them die soon after being dis- 
charged, from disease contracted while in prison. 

The death-rate among our county convicts is more 
distressing than that among our State convicts. For 
the past ten years ( from 1890 to 1900 ) the average an- 
nual death-rate of county convicts has been eight per 
cent per annum, or eighty per thousand, an annual rate 
of twenty-four per thousand, greater than the death-rate 
among State convicts, and a rate nearly five times great- 
er than in the State at large. 

All these figures include deaths from violence, as well 
as from disease, because, such deaths go to make up the 
general death-rate in the State at large. 

The main cause of this excessive death-rate among 
county convicts, over the very large death-rate among 
State convicts, is due to the fact that the State, in leasing 
its <!onvicts, does not assign to the contractors men who, 
when received from the jails, are too sick or feeble to do 
a fair day's work, but employs such men upon its farms, 
or in its cotton mill ; or supports them, if unfit for any 
kind of work, in the penitentiary at Wetumpka, where- 
as, the different counties, having no such resources, 
hire all of their convicts, regardless of their physical 
condition, to contractors — chiefly to coal mining con- 
tractors, resulting in the increased death-rate I have 
pointed oul 

In speaking of this large rate of mortality in ouk 
penitentiaries I am reminded of Dr. J. B. Gaston's 
famous words on the subject, nearly twenty years ago. 



406 MORTALITY I2f OUB PBIBON POPULATION. 

He says: '^They were sentenced to hard labor in the 
penitentiary and they have been put to death/' 

I would that I could arouse in the minds of all who 
may hear or read this paper a small portion of the in- 
terest the words of Dr. Gaston^ just quoted, stirred up 
in the people of Alabama at that time, for, in all earn- 
estness, I stand here to-day and tell you that, perhaps in 
a modified degree, we are doing now just what he com- 
plained of then. 

The State of Alabama is not treating its convicts 
with that degree of justice and humanity we have a 
right to expect from so grand a commonwealth. 

But, if our prison death-rate is exorbitant when com- 
pared with the death rate in the State at large, it is 
made to appear only more appalling when we compare 
it with the death-rate in the penitentiaries of some 
other States, which I do not believe are any more in- 
telligent, or advanced in civilization, than we are. For 
instance, the mortality rate in the State penitentiaries 
in Texas for 1898 to 1900, was thirty per thousand, 
while ours was forty-four per thousand. In the peni- 
tentiaries in California, from 1898 to 1900, the rate was 
twenty-two per thousand, or leas than half of our low- 
est rate. In the Colorado penitentiaries the death rate 
for 1898 to 1900 was only ten per thousand, or less than 
one-fourth of our lowest rate. In the three peniten- 
tiaries in the State of New York — ^Auburn, Clinton and 
Sing-Sing, in 1899, the rate was from two-thirds of one 
per cent, to one per cent, while in Alabama it was four 
and two-fifths per cent or about five times as great. In 
Florida the rate is less than our average, and as low 
as our lowest. In Mississippi the rate is about the same 
as ours. In Louisiana the rate is fearful — ^a good deal 
larger than ours — ^but, as if ashamed of themselves, the 
people of that State incorporated a provision in their 
new State Constitution, adopted in 1898, that upon the 
expiration of existing contracts their convicts should 
not again be leased. In Tennessee, the death-rate is less 
than twenty per thousand for the period of 1898 to 
1900. In Georgia, a State similar to our own, with only 
the waters of the Chattahoochee between, and with its 
convicts, like ours, mostly negroes, the average rate for 
the past ten years among its State convicts has been 
less than twenty per thousand, while ours for the same 



JUDBON DAVIS. 407 

time has been fifty-six per thousand, and eighty per 
thousand among our county convicts. 

While it is a fact that in some of the States I have 
named the bulk of the convicts are white people, and 
would naturally have a smaller death rate than ours, 
still the great differences cannot be explained from 
racial causes alone. 

So, then, this brings us to the very important ques- 
tion : Why do we have a death rate so much in excess 
of that naturally to be expected from causes ordinarily 
existing in prison confinement, and so much in excess 
of some other State penitentiaries? The answer is to 
be found mainly in the fact that our convicts, both 
State and county, are leased to coal mining contrac- 
tors, regardless of their physical condition and regard- 
less of their ability to perform such labor and live. 

We are forced to this conclusion from a careful study 
of the reports of the prison officials themselves. 

These reports all show that the death-rate is small 
among convicts doing farm work, saw mill work, tur- 
pentine work, lime-making, brick-making, or any other 
kind of work performed in the open air and sunshine — 
pursuits in which most of the convicts were engaged 
prior to their incarceration in our penitentiaries, and 
involving no radical change in their former modes of 
life, as does mine work. 

Of course, convicts who are engaged in these pursuits, 
in the open air and sunshine, do not die nearly so rap- 
idly from a number of diseases that are incident to coal 
mining operations, where men aro congregated in 
prisons in large numbers, to- wit: tuberculosis in its 
various forms, pneumonia, pleurisy, diarrhoea, and 
other germ diseases, to say nothing of quite a number 
of fatal accidents. Speaking to a body of medical men, 
I need not take time to elucidate this proposition. Suf- 
fice it to say that for the past ten years, from 1890 to 
1900, the prison reports show that nearly half of all 
deaths occurring among State convicts were caused by 
tuberculosis in some form; and the reports also show 
that the majority of all these cases were contracted at 
the mines. 

A great deal has been said and written upon the sub- 
ject of separating the tuberculous from the non-tuber- 
culous convicts, and it ought to be done* It would be 



4f^ MORTALITY IN OVR PRiaOK POPULATION. 

of much importance to those not infected with the 
disease. But, that is not all that should be done; for, 
most of the diseased would, perhaps, die after being sep- 
arated from the uninfected, even though their lives were 
prolonged for a time. What we want to do is to stop 
the manufacture, so to speak, of tuberculous conditions 
in convicts; to withhold the material, namely, the fee- 
ble and physically unsound men, out of which consump- 
tives are made from subjection to conditions and en- 
vironments whch develop the diseases so readily; to 
keep feeble and unsound men out of the mines ; to keep 
them away from the mines. 

I think our last Legislature took a step in the right di- 
rection when it provided for separating tuberculous from 
non-tuberculous convicts. But, in my opinion, it is a 
subject that should be handled carefully, lest in congre- 
gating tuberculous prisoners we may hasten the doom 
of many of them. My idea would be a large enclosure 
for the confinement of tuberculous convicts, supplied 
with tents, at stated distances from each other, in which 
the convicts should be required to live, eat, sleep, separ- 
ate from each other. And when too feeble to do this 
they should be sent to a hospital constructed with this 
same paramount idea of separation^ open air, and sun- 
shine. For, tuberculosis is not like the contagious dis- 
eases which run their course in a short while, and there- 
fore, may be congregated. It is a disease that lasts in- 
definitely — as long, in fact, as the infected person may 
live. 

But I trust you will pardon me for this digression. 
The reports of the Convict Inspectors all show that the 
death-rate among first class convicts who are worked 
in coal mines is small; that it is somewhat greater 
among second class men, but still reasonable — ^and that 
it is very large, indeed, among third and fourth class 
men. 

Dr. R. Aug. Jones, then State physician, very clearly 
shows this to be true in his report for 1888 to 1890. 
And again in his report for 1890 to 1892, in discussing 
the matter he says: "It thus appears that less than 
one per cent, of the first class convicts die per annum. 
Less than two per cent, of the second class die per 
annum, while nearly ten per cent, of the third and 
fourth classes die per annum.'' 



i 



JUD80N DAVIS. 409 

He also gays in this report, "I repeat here, to em- 
phasize the great lesson taught by these facts, that 
none but first and second class convicts should work 
in coal mines." In his report for 1896, our worthy 
president of this Association, Dr. Cunningham, in dis- 
cussing the rate of mortality, points out very clearly 
that by far the greatest death-rate among convicts at 
the mines is among the third and fourth class men. 
He says: "These figures show conclusively that more 
than two thirds of the mortality is among less than 
one-half of the convicts, to-wit: the third and fourth 
classes." 

This statment alone, disconnected from any other 
testimony, coming as it did from a former State Phy- 
sician, and one who for the past fifteen or eighteen 
years has been physician for the convicts in the employ 
of the Tennessee Company at Pratt Mines; and than 
whom no one in Alabama is better posted on convict 
matters, ought to have had great weight in shaping the 
future policy of the State toward the employment 
of its convicts in mine labor. But it did not ; for, like 
the sow spoken of in the scriptures, the State returned 
again to its wallowing in the mire, and repeated its 
reprehensible, indiscriminate lease act, so hazardous 
to the lives of many of this unfortunate class. 

A great many at these facts, concerning the health 
and mortality of convicts worked in the mines, were 
known to our State o£Bicials, even prior to i887, when 
a lease was made for ten years of all the State convicts 
who were able to do anything like a fair day's work 
when received from the jails into the penitentiary. 
For the reports of the Inspectors show a death-rate 
nearly three times as great among those who were then 
worked in mines as those who were worked on farms. 

In 1882, at the time Dr. Gaston so vigorously criti- 
cised the State penitentiary, in his annual address 
as president of this Association, the reports show that 
the death rate was nearly five times as great among 
those in mines as those on farms. 

The Inspectors in their report for 1882 to 1884, say : 
"The sickness at the mines and the mortality there, 
both from disease and accident, are strong arguments 
against the employment of convicts in that kind of 
labor." And in this same report we find that in many 



410 MORTALITY IN OUR PRISON POPULATION. 

instances among those engaged in fanning the death 
rate was only about one per cent., and in some places 
not that high. 

I think I am safe in saying that in no case, down to 
the present time, does the higtiest death-rate among 
convicts on farms, and those working at other open air 
pursuits, including the poorest physical classes, exceed 
one half of the lowest death rate among those worked 
in mines, in which are included all the robust men. 
In many instances the rate is not as great as one half. 

And then after the ten years lease expired, with the 
reports of all the prison officials, especially the medical 
reports — teeming with convincing facts against such a 
policy, a lease to coal mining contractors was again 
made for five years upon the same basis as the ten years 
lease just closed — and the unsightly blot of an exorbi- 
tant death-rate still mars the records of our State in- 
stitutions. 

^^Man's inhumanity to man," in this matter, is still 
conspicuous and is stamped with the approval of Ala- 
bama's law making powers. 

I consider the last official utterances on convict mat- 
ters, jnade by our wise and beloved brother, the late 
Dr. Cochran, tlien State Health Officer, as being worthy 
of being repeated in connection with this paper. They 
were made in a report to Governor Oates in 1895, and 
are as follows: '^The situation that confronts us is a 
very embarrassing one. We have good prison manage- 
ment and so far as we are able to discover we have good 
prisons, and abundant attention to the commonly ac- 
cepted principles of sanitation; and yet with all this 
we have a persistently high death-rate — ^a death-rate 
that is high all the time, with occasional exacerbations, 
when, it becomes verj high indeed. An analysis of 
the causes of the deaths shows that the regular mor- 
tality is due to a very miscellaneous assemblage of 
causes, while the exacerbations are due to outbreaks 
of epidemic or germ diseases, such as pneumonia, diar- 
rhoBa, dysentery, and especially tuberculosis, in acute 
and chronic forms, and affecting various organs. 

Tuberculosis is, of course, a permanent factor of the 
death-rate, but it seems occasionally to assume the 
character of an epidemic, as, at Pratt Mines in the 
month of May just past Our convicts are mostly 



JUDBON DAVIE. 411 

negroes. It is probable that a goodly number of them 
are not in first class physical condition when they reach 
the mines. The life and labor of the mines is a new ex- 
perience to them, and involves radical changes in all 
their habits and surroundings. They have been accus- 
tomed to the largest liberty of action ; but now they are 
confined in very narrow limits. They have been accus- 
tomed to the sunshine — ^are indeed the very children 
of the sun ; but are now cut ofif almost completely from 
all opportunity to bask in the rays of that great lumi- 
nary. In the meantime, they become demorilized and 
suffer from nostalgia, and in many ways become less 
able to resist the encroachments of disease; and on ac- 
count of being crowded together in such large numbers 
they are specially liable to suffer from invasions of 
epidemics. 

Work in the mines is not itself especially unwhole- 
some. Free miners do not show a high death-rate. But 
our experience in Alabama seems to prove that there 
is something in the life of miners and in the work at 
the mines that is inimical to the physical welfare — to 
the health and longevity, of our negro convicts. This 
being so, it would seem evident that none but strong 
men in good health should he put to work in the mines/^ 

While I joined and assisted Dr. Cochran, as Physi- 
cian-Inspector of Convicts, in preparing this report, and 
in making the investigation into the cause of the speci- 
ally high death rate prevailing at that time among the 
convicts at the mines in Jefferson county, still, the re- 
port was written almost entirely by Dr. Cochran, and 
bore the unqualified approval of his great mind. 

I read just now that "Free miners do not show a high 
death rate." It should be borne in mind, however, that 
^ree miners, parts of every day, and on Sundays and 
hi lldays, when not working in the mines, are at liberty 
to enjoy the vitalizing elements of open air and sun- 
shine, and are not congregated, like convicts, in large 
numbers, in prison. Convicts never have such oppor- 
tunities; nor are free people under the mental pressure 
and dissatisfaction that must necessarily exist among 
people imprisoned. 

The Physician-Inspector of Convicts in his last re- 
port (1898 to 1900) says: "The health at the small 
camps has been remarkably good^ only 17 deaths hav- 



412 MORTALITY IN OUR PRISON POPULATION. 

ing occurred at fourteen small camps. Fifty to one 
hundred convicts are kept at each of these small camps, 
and they are employed at farm work, in lime kilns, saw 
mills, and turpentine manufacturing." I think the 
rate of these ^^small camps" does not exceed 1^ per cent, 
per annum, although it is not specially stated in the 
report. 

And this is the secret of the small death-rate in the 
Georgia penitentiary. Only about one fifth of her State 
convicts — ^and the best men physically — ^are worked in 
mines. The others are scattered all over the State in 
^'small camps" and engaged in various kinds of open 
air employments. 

So, then, it appears that after full and sufficient 
notice of the evils connected with her course of hiring 
the bulk of her convicts in large numbers to coal min- 
ing contractors, the State continues to pursue the same 
policy. She shuts her eyes to the unnecessary rigors 
of her penal system, and stops her ears to the cries of 
many of her unfortunate criminals, as they go down to 
premature graves. 

And why, pray, does she so persistently pursue such 
a course? The only reasonable explanation is to be 
found in the fact that it puts money into the vaults of 
the State Treasury. 

It would be somewhat s^hocking to our sense of civili- 
zation and refinement to say, in cold figures, that the 
lives of «o many of our criminal population, after being 
incarcerated in our penitentiaries, had been deliber- 
ately sacrificed for the sake of putting so many thous- 
ands, or tens of thousands, of dollars into our State 
Treasury, — ^and yet, such a statement would not be very 
far from the truth. 

When the State puts third and fourth class convicts 
into the mines, and suffers the different counties to do 
the same, knowing them to be unfitted to perform such 
work and live, and that those same men put to work 
on farms and at other open air employments do perform 
such kinds of labor and live, it seems to consent, and 
become a party, to the increased death-rate at the mines 
for the sake of the increased pay the coal mining con- 
tractors can pay, over contractors engaged in other 
avocations. For no other kind of work in this State 
pays anything like the returns for convict labor that 



JUDaON DAVJB. 413 

mine work pays. No other class of contractors can pay 
the prices for convict labor that mining contractors 
can pay. And this fact above all others, accounts for 
90 many of our con/victs being worked in coal mining 
operations, and this, in turn, accounts for the excessive 
death-rate among the prison population of this State. 
The State puts itself, in this matter, in the light of an 
avaricious money-getter, and that too, at the sacrifice 
of human life. 

This is a very large subject — one on which a volume 
could be written. But, I have only been able, in this 
paper, to jot down a few of the most prominent ideas 
that have come into my mind. 

I cannot leave it, however, without expressing the 
hope that this Association, which is the highest medical 
tribunal in the State, and whose official utterances, 
acts, and recommendations ought to have great weight 
in guiding and directing our State in matters of this 
sort, will take some action at this meeting in regard to 
it. 

It seems to me that if some disease in the State were 
destroying the lives of a large number of people in excess 
of the ordinary death-rate, our State Board of Health 
would be active in its official efforts to suppress and erad- 
icate it. And I know of no good reason why official action 
should not be taken by our health officials to induce our 
law-making powers to put down an excessive death-rate 
caused by the unnecessary rigors of our penal system. 

And, it seems to me, the best way to reach the trouble 
is through the law-making power of our State. For it 
appears, in the light of our past experience, that so 
long as the law lets it remain possible for zealous State 
officials, mercenarily inclined in the interest of the State, 
to sacrifice the welfare of our convicts, from a health 
standpoint, it will be done. 

It seems to me the best way to reach our law-making 
power in this matter is through the official executive 
arm, so to speak, of our State Medical Association, to- 
wit: Our State Board of Health — especially when so 
instructed and advised by this Association. 

I think that one or two short bills enacted into laws 
on this subject would put the matter in much better 
shape. We need a law providing that upon the expira- 



414 MORTALITY IN OUR PRISON POPULATION. 

tion of present contracts^ or at once, not more than one- 
fourth or one-third of the State's ablest convicts shall 
be leased to mining contractors ; and that these shall be 
changed from time to time, when necessary on account 
of health conditions; that a violation of this section 
shall be ground for impeachment proceedings against 
all officials by whom it is disregarded. 

In the second place, the different counties of the State 
should not be allowed to hire any of their convicts to 
work in the mines but men who are physically sound, 
in all respects, and who have been so pronounced by a 
competent medical examiner. And let the same penalty 
attach to violations of this clause, as already stated 
above. 

County convicts should not be worked outside of the 
counties in which they are convicted. In my opinion, if 
these few principles were incorporated into law an un- 
sightly blot in the history of our State penitentiary 
would be removed ; and our faces would not have cause 
to blush with shame when the dealings with our con- 
victs were held up to the scrutiny of a civilized nation. 

In conclusion, I must state that the history of our 
penitentiary shows that most of the efforts of the State 
to work its convicts on its own account have proven fail- 
ures, and frequently brought the State largely in debt — 
especially in the early 'history of the penitentiary. 
It was this cause that gave rise to the lease system, which 
is still in vogue. But, I am satisfied that if contractors 
can make convict labor profitable and pay hire to the 
State, the State, having no hire to pay, can, at least, 
make its penitentiary self-supporting. The idea of mak- 
ing the penitentiary a vast money-making machine is all 
wrong, and should not be tolerated, when it sacrifices the 
health and lives of so many convicts. 

And then, again, in the light of an advanced and civi- 
lized age, the State has no moral right to delegate its 
duty and responsibility to discipline and reform its 
criminals to a lot of contractors— corporations which 
are avaricious at best, and whose highest interest is the 
money they can make out of convict labor. 

The State, of course, has a right, and it is the duty of 
the State, to protect society; but it has no moral right 
to sacrifice the lives of its criminals for the sake of large 

profits- . : I . l..r'itafii^ 



JUDBON DAVIB. 415 

It is also true that in many of the State i)enitentiaries 
I have named as having a very reasonable death-rate, 
convicts are not leased at all, the legislatures of those 
States making large annual appropriations to help main- 
tain their penitentiaries. None of them are attempting 
to convert the labor of their convicts into a vast money- 
making power, as we are doing, and thereby, incidentally, 
sacrificing the lives of many human beings. 

Are those States less avaricious than we are? Are 
they more humane and civilized? Are they more patri- 
otic and public spirited? 

I do not believe it. I think it is largely because the 
matter has never been properly brought to the attention 
of our people. I believe there are no better, nor more 
civilized, and enlightened people in the world than those 
of Alabama. But, good people, sometimes, as States and 
communities, do wrong. 

Let us protect society; let us discipline and reform 
our convicts, as best we may; let us work them — and 
even lease some of them out, if necessary, to the extent 
of making our penitentiaries self-supporting; let us 
punish them when necessary ; but inasmuch as they are 
human beings, and completely helpless and powerless to 
resist ill-treatment, let us spare their lives and treat 
them with justice and humanity. 

DISCUSSION. 

Dr. I. J. Sellers — I am glad to have heard the paper 
just read. The author discussed his subject very fully, 
and emphasized the importance and humanity of dimin- 
ishing the high mortality in our prisons. He failed, 
however, so far as I noticed, to call attention to what 
I consider one of the fruitful causes of that mortality, 
namely, the great prevalence of syphilis among our negro 
Ix)pulation. The doctor very properly says that the large 
part of the inmates of our prisons are negroes, and that 
they are especially susceptible to tuberculosis. 

I think that every physician, of even a few years' ex- 
perience, has noticed that a very large percentage of 
tubercular cases among negroes give a history of having 
had syphilis, or show conclusive signs of that disease. 



416 MORTALITY IN OUR PRISON POPULATION. 

Now, with their constitutions already undermined by 
syphilis, if put in prison and deprived of freedom, fresh 
air, and sunshine, they fall easy victims to tuberculosis, 
and a high mortality results. The remedy obviously 
lies in two directions : Either syphilis must be extermin- 
ated from among them, or they must not be worked in 
mines ; that is, the weaker and less vigorous ones. 

A syphilitic negro, who, if imprisoned and worked in 
a mine, will soon die from tuberculosis, may live a long 
time and do efficient work on a farm, or in other 
place where he gets abundance of fresh air and sun- 
shine. 

That syphilis plays an important part in causing the 
high mortality in our prisons should be kept in mind. I 
believe it would be good policy to subject all negro con- 
victs who present evidences of syphilitic infection to a 
thorough course of anti-syphilitic treatment before as- 
signing them to work in mines, especially, as the very 
large majority of them who have been poisoned with the 
disease have never had the benefit of such a course of 
treatment. 

Dr. L. A. Jenkins — I agree fully with the views ex- 
pressed by the last speaker (Dr. Sellers) as to the part 
syphilis plays in producing a high mortality among the 
convicts in our prisons. The very large majority of the 
negroes who go there have previously contracted syphi- 
lis, and, when placed in foul and vitiated air, their health 
becomes undermined and they become good soil for the 
germs of tuberculosis to feed upon. My observation at 
Brookside, one of our mines, w^here two-thirds of the 
miners were negro ex-convicts, convinces me that nine- 
tenths of them were suffering from either scrofula or 
syphilis, as very often I could find evidences of the ini- 
tial syphilitic lesion. I noticed also that ex-convicts did 
not stand any kind. of fevers or injuries well, death 
nearly always claiming the victim. 

In conclusion, I desire to repeat that the cause of so 
much tuberculosis in our prison population is not so 
much the presence of the germs of that disease, but the 
fact that they find such a fertile soil in which to grow, 
rendered so by previous dyscrasisB, chiefly syphilis. If 
we could eradicate syphilis from among the negroes, 
we would not have so much tuberculosis iti our prisons. 



THADDJBUa AIMUZO CASBT. 4)L7 



THE PREVENTION OF INFECTIOUS DISEASES. 



mmmmm 



By Thaddbus Alonzo Casibt, M. D., Alhe^tvillb, Ala. 
Member of the Medical Aisoclatlon of the State of Alahama. 



The ultimate object of human effort is happiness; 
but disease and death destroy happin^s, and bring 
pain and sorrow instead. 

The preyention of one epidemic of yellow fever, small- 
pox, or typhoid fever, is valuable beyond computation 
in dollars and cents, and should, therefore, whenever 
possible, be accomplished regardless of cost. 

However brilliant may be a surgical operation for the 
relief of appendicitis, hernia, etc., it concerns but one 
person; whereas, a single case of infectious or conta* 
gious disease, concerns primarily the whole surrounding 
population, and secondarily, the entire population of the 
State. Indeed, it often happens that the announcement 
of a case of infectious disease in a region, however re- 
mote, excites the interest and attention of the whole 
civilized world. 

The above being undeniably true, it follows that no 
subject deserves more serious and careful consideration 
by individuals, communities, States and Nations, than 
the prevention or control of contagious or infectious epi- 
demic diseases. It is not strange, therefore, that 0ome 
of the greatest intellects in our profession have been 
devoted to the study of this subject, and the labors of 
such men as Jenner, Eberth, Koch, Pastuer, and many 
others, have accumulated a mass of useful knowledge 
concerning the etiology and pathology of such diseases 
that is more valuable to mankind than it would be easy 
to estimate. It is strange that under these circumstances 
and in the light of repeated demonstrations, there can 
still be found, not only among the intelligent laity, but 
even in the ranks of medicine, men who question the 
truth of modern discoveries, even to the usefulness of 
vaccination. 

If a beneficent discovery like vaccination, whose pro- 
tection has been so thoroughly demonstratedi »tiU meatQ 

26 



418 ^^^ PRBVBNTION OF IlfFBOTIOUB DI8SA8B8. 

With doubt and opposition at the end of a hundred years, 
the outlook for the acceptance of scientific truths not 
8o easily demonstrable to the laity is not encouraging. 

There are constitutional doubters everywhere, meo 
who doubt everything, and our profession is not free 
from their pernicious influence. 

Until by education of our doctors in the brilliant re- 
sults of modern investigation, we can present an un- 
broken front to the skeptisism of ignorance, we cannot 
hope to accomplish the complete downfall of opposition 
to the measures necessary for the protection of humanity 
against contagious epidemic diseases. When every phy- 
sician is qualified to instruct his clientele how to pro- 
tect themselves against such contagions as typhoid fever, 
pulmonary tuberculosis, diphtheria, etc., and makes it 
his duty to do so, on all proper occasions, the general 
public will soon become educated to a point that will 
insure their support of every sanitary measuro we find 
it wise to suggest. It is along this line that the suc- 
cess of public sanitation lies. 

This paper \nl\ call special attention to three divisions 
of the subject. First, the modes of conveyance of infec-^ 
tions; second, the importance of early diagnosis, as a 
sanitary necessity ; third, the duty of the State to provide 
facilities for accurate scientific investigations, and for 
the care of the consumptive poor. 

If we know from what quarter a danger threatens 
us, in what shape it will come, and what will bring it, 
as well as what will not bring it, we are at once placed 
in a position favorable for defence. 

We know that hydrophobia is transmitted by the bite 
of a rabid animal, and the knowledge enables us so to 
control the distribution of rabies that most physicians 
will spend their lives in active practice without ever 
seeing a case. Indeed, so rare is the disease, that some 
of the constitutional doubters doubt its existence. 

I believe that the propagation of each and every con- 
tagious disease could be as certainly and efficiently pre- 
vented as rabies, if we as thoroughly knew and under- 
stood the means by which it could be communicated. 

As it is, every human being should know that a slight 
exposure to a mild case of a contagious disease may be 
followed, in the person exposed, by an invasion of the 
severest type. Thus, varioloid may communicate fatal, 



THADDEU8 ALONZO CASEY, 419 

confluent smallpox; the sting of one infected mosquito, 
if the latest theories be correct, may result in a ma- 
lignant yellow fever, and a single drink of water can 
convey the germs of death from typhoid fever. These 
truths should be proclaimed everywhere, until the laity 
would learn to protect themselves from unnecessary dis- 
ease and suffering. 

Infection and toxaemia differ widely. Toxaemia, pois- 
oning of the blood, as by the bite of a snake, is fatal or 
not, according to the power of the patient to endure the 
results until the poison is eliminated. But infection is 
the sowing of the seeds of disease, which will germinate 
and multiply beyond computation. Concerning the 
manner of transmission of infections, there has been 
much discussion and difference of opinion. 

Dr. A. H. Doty, Health Officer of the port of New 
York, after an immense experience, and the most favor- 
able opportunities for observation, says that most of 
the laity and many physicians believe infection can be 
transmitted from a sick person to a well one by the 
clothing worn by a third who has been exposed, but is 
not infected. That is to say, clothing can carry infec- 
tion. This he calls a seductive theory, but states that 
in an experience of over twenty years spent in dealing 
with infectious and contagious diseases, he has not seen 
a single case in which the disease was transmitted in this 
way. In almost every case where such transmission was 
suspected it could be shown that the persons affected 
had been in contact with others sick with the same dis- 
ease, though perhaps, in an extremely mild degree. 

He gives numerous instances, which the limits of 
this paper, mil not allow me to quote, where nurses, at- 
tendants, ambulance drivers, surgeons and other inmates 
of hospitals devoted to the care of patients suffering 
with smallpox, typhus fever, and other contagious dis- 
eases, went freely in and out of the hospitals, mingled 
with their friends at large, and spent their nights at 
home with their families, and in no instance did these 
men communicate typhus fever or smallpox to their 
friends. 

That insects are the carriers of disease is no new 
theory. 

It is well known that the cattle tick is the carrier of 
Texas fever, and the common domestic fly is almost 



420 ^^^ PRBVWTION OF JNFWCTWU8 DISBABBS. 

known to be capable of transmitting the bacilli of 
typhoid fever. The current theories concerning the re- 
lation the anopheles mosquito bears to the transmission 
of the malarial parasite are well known. The recent in- 
vestigation of the part the culex mosquito plays in epi- 
demics of yellow fever is no new thing. Twenty years 
ago Dr. Finlay of Havana made experiments along this 
line, by causing infected mosquitoes to bite fresh re- 
cruits from Spain, and the conclusion reached by him 
and his collaborator, Dr. Delgado, was that the trans- 
mission of yellow fever by the culex needed no further 
proof. In 1881, he read a paper on the subject before the 
Havana Academy of Sciences. The recent experiments 
of Drs. Reed, Carroll, Agramonte and Lazear, of the 
United States army, resulting in the martyrdom of Dr. 
Lazear for the sake of science, are fresh in our minds. 
Suffice it to remind you that their conclusions are simi- 
lar to those of Dr. Finlay. If further observations con- 
firm these conclusions, sanitarians will have the fly and 
the mosquito to fight instead of fumigating freights 
and cargoes, and the clothing of travelers. 

Upon whatever else sanitarians may disagree, all are 
united in the belief that the patient sick with an infec- 
tious disease can communicate it to any well person, 
who is not immune. Therefore, it follows that it is of 
supreme importance, when a patient is thus affected, 
that the nature of his disease should be recognized at 
the earliest possible moment. 

The treatment of the patient and the protection of 
the public demand this. This is especially true of tuber- 
culosis. As when a house is on fire the detection of the 
fact before it has spread to an uncontrollable degree is 
all important, so is it with infectious diseases. In such 
cases concealment, or failure to recognize, means an epi- 
demic, with all its dangers, losses, and terrors. In Janu- 
ary, 1900, a young man fled from Alabama City on ac- 
count of smallpox, and stopped at his father's home, ten 
miles from mine. He sickened and died the third day, 
and though I had not seen him, I had no difficulty, from 
the description of his case, in pronouncing it smalli)ox 
of haemorrhagic type. Providing myself with virus, I 
went there to vaccinate the people of the neighborhood, 
to protect them from danger. To my chagrin, they de- 
clined. Twenty days later the young man's father was 



THADDEU8 ALONZO CA8XY. 421 

taken ill with typical symptomB of smallpox. I saw 
him the third day, but he had diagnosed his own ease 
as ^^a bad cold." On the tenth day he died with confluent 
smallpox* 

At my first visit to him the family, convinced and 
alarmed, consented tx) be vaccinated* There were six of 
them. Three had smallpox, three varioloid. All recov- 
ered. The county spent five hundred dollars, business 
was suspended, schools and churches closed, and a state 
of partial panic prevailed. All this might have been 
avoided, and at least one life saved, by tiie early diag- 
nosis of the first case, and general vaccination. 

In the same year a young lady in my neighborhood 
died with typhoid fever, contracted while visiting a 
house where there was an ambulatory case of the dis- 
ease, in daily association with the family. Another 
case originated, so far as I could judge from my investi- 
gations, from a single drink of infected water. The 
lesson to be learned from such instances is first, a 
knowledge of the existence of the danger; second, a 
knowledge of its manner of propagation ; third, a knowl- 
edge of the means of avoiding infection. All these things 
should be known by the general public. 

The State should maintam a sanatorium for the care 
of the Consumptive Poor. 

For reliable statistics concerning the ravages of pul- 
monary tuberculosis I have relied upon the statements 
of the Health Department of the Sanitary Bureau of 
New York. These statistics show that there is an aver- 
age of 172 deaths per week in the city of New York 
from tuberculosis. This is equal to 8,944 deaths per 
year ! Think of it ! More than one death for every hour 
of the year in one city from one disease alone. 

The ravages of any disease of appalling fatality have 
usually given to that disease the name of a plague. The 
same consideration has caused pulmonary tuberculosis 
to be termed the great white plague. Last year it was esti- 
mated that in the city of Baltimore alone there were 
10,000 cases. Medical literature teems with articles 
concerning it. A "Tuberculosis Congress'^ is to meet in 
London this year, and Prof. Robert Eoch will give the 
opening address. There is no disease in the entire list 
that slays more victims and commands more study at 
home and abroad. As a result, the importance attribut- 



422 ^^^ PREVSNTIOIf OF 1NFBOTI0V8 DIBSABBB. 

ed to heredity in its propagation has been greatly modi- 
fied. It is now believed that though a susceptibility 
may be inherited, the disease itself is almost never 
planted in the system of the unborn child. This being 
true, it follows that the seeds of the disease are com- 
municated from the sick to the well ; and, f urther^ that 
if the disease can be recognized in its incipiency, it can 
be controlled, segregated, and finally obliterated, from 
the earth. Modern experience points out as the best 
house for a consumptive, one consisting only of roof and 
floor, with adjustable side walls of canvas. The State 
should provide Sanitaria like these for the care of the 
consumptive poor, where they could be maintained in 
comfort, and under t^rcumstances most favorable to 
their recovery, and at the same time suitable regulations 
could be enforced for their protection from self-reinfec- 
tion, and from their disemminatix^ the germs. 

The State should also maintain a Laboratory of Pathol- 
ogy, where, free of all cost, the different counties could 
have made such microscopical, chemical, or oultural in- 
vestigations as the conditions might demand. 

A small sum of money thus expended would return m 
large sum of vitally useful information to our citizens. 

Dr. Wyman, in his paper, read at the Pan-American 
Medical Congress in Havana, places the importance of 
sanitary conferences above that of the Peace Confer- 
ence at The Hague. There can be no doubt of the im- 
portance of this matter, nor of the fact that it is one 
subject concerning which all nations are in harmony. 

Something has recently been said about establishing 
a permanent home for this Association. Should such 
a home ever be established, I would like for this in- 
scription to be emblazoned on its walls in the most con- 
spicuous position: 

SANITATION IS THE CEOWNING ACHIEVEMENT OP MEDICINE. 



BAMVEL WALLACE WELCH. 



423 



CLIMATIC EFFECTS IN TALLADEGA COUNTY 
ON DISEASES COMMON TO ALABAMA. 



Samukl Wallacs Welch, M. D., Tallaobga, Ala. 
Junior Counsellor of the Medical Association of Alabama. 



Talladega m situated in the southern border of the 
northeastern grand division of Alabama, which com- 
prises the mineral region of the State. Two ranges of 
the declining ridges of the Appalachian Mountains trav- 
erse it from the northeast to the southwest. One of 
these ranges divides it from Clay county, on the east, 
while Coosa River forms its western and southern boun- 
daries. Three large streams of water have their sources 
in these mountains, and find their way across the 
county to the river, being fed on the way by numerous 
springs and rivulets. The water is, as a rule, hard lime- 
stone, with, here and there, a mineral spring, at least 
two of which — Talladega and Chandlers — have gained, 
for their localities, some celebrity as health resorts. It 
is a picturesque, hill country, usually cool and healthful 
in summer, genial and temperate in winter; but, in 
spite of all that, the inhabitants sometimes get sick; 
and to some of the more common diseases I invite your 
attention to-day. 

Malaria takes precedence of all other morbid condi- 
tions, coloring, more or less, all the ills that aflUct our 
people. Proximity to the river increases the liability 
to infection, but residents in the mountains are not en- 
tirely immune. Manifestations of malaria are more pro- 
nounced and varied in summer and fall, but we meet 
them, in some localities, at all seasons of the year. At 
the request of Dr. H. A. Moody, special observation was 
made in the spring of 1900 to ascertain the relation be- 
tween the earlier manifestations of malaria and the ap- 
pearance of the mosquito. It was found that many cases 
of intermittent malaria appeared before the advent of 
the mosquito. The first abundant crop of mosquitoes, 
(both brown and spotted), was not followed by an in- 
crease of malarial diseases; but an increase succeeded 



4ii4 OLIMATW SFFEOfS /l^ TALLADEGA OOVKTY. 

a few days of excessively wet weather, which terminated 
a drought of some weeks. Not since 1866 has there 
been such an epidemic of malaria as followed this out- 
break, which persisted without intermission until late 
in the fall. A number of interesting observations were 
recorded which seemed to discredit the accuracy of the 
conclusions drawn from the experiments of Dr. Manson, 
in Southern Italy, Major D. M. Andrews, of the United 
States Engineering Service, in charge of Lock 4 on 
Coosa River (a man of character, observation, and 
scientific training), erected a mosquito-proof cottage 
before the arrival of his wife from the mountains of 
East Tennessee. In one month after she reached Lock 
4 she was stricken with intermittent malaria. Quinine 
effected a cure. The drinking water was then boiled, 
and the family remained immune, with the exception of 
a brother, who refused to drink the boiled water until 
after he had fallen a victim to one spell of chills. This 
spring the same family, living in the same cottage, and 
drinking boiled water, have had malaria before the ad- 
vent of the mosquitos. In another family, on another 
section of the river, without any protection from mos- 
quito^, with like environments, both for the night and 
the day, eight had malaria and two did not. In still an- 
other family in the interior of the county, with no pro- 
tection of any sort, the father and three sons had inter- 
mittent malaria in a most violent and intractable form, 
while the mother and another son were immune. In 
the same locality, two brothers ate together, slept to- 
gether, and worked together. One had chills, and the 
other was immune. 

Many other suggestive observations, not germane to 
this paper, were made. The conclusion, however, seems 
justified, namely, that several factors enter into the in- 
fection and propagation of malaria, the most potent of 
which is, perhaps, a lowered vital resistance induced by 
atmospheric disturbances, environments, habits of life, 
and dietary. It seems more than probable, too, that 
there are three modes by which the individual becomes 
inoculated with the specific infection; the water we 
drink, the air we breathe, and the bite of the mosquito. 

Typhoid fever is with us, more or less, all the time. 
It differs in some degree from the typhoid fever seen in 
the Charity Hospital at New Orleans, and very essen- 



BAMVBL WALLACE WELCH. 425 

tially from that seen in Baltimore. I have never seen 
a typical case of typhoid fever in Talladega county, such 
as is met with every day in Baltimore. There seem al- 
ways present two elements of infection which find ex- 
pression in a typical symptom. In some cases the ma- 
larial element predominates; in others the typhoid ele- 
ment predominates; and the case is mild or severe, ac- 
cording to this leaning to type. 

I would not be understood to argue that a mixed fever 
exists, but I do most emphatically believe that at cer- 
tain seasons of the year the two poisons do co-exist in 
almost every case we see, the one poison accentuated by 
the other, and both appealing to the watchful care of 
the attending physician. No blood examinations have 
been made of these cases by the writer, but cases were 
closely studied clinically during the period covered by 
microscopical investigations made by Dr. W. G. Harri- 
son, and reported to the last meeting of this Associa- 
tion. These examinations seemed to confirm theories 
previously held by leading clinicians of the country. 

You will naturally conclude from our variable cli- 
mate that pulmonary and catarrhal troubles are not 
infrequent. Asthma is a trouble almost unknown among 
us, and imported cases seem much benefited by residence 
with us. Pulmonary consumption is not so infrequent 
among white people as formerly, but is markedly on the 
increase among the negroes. Each epidemic of influ- 
enza in the spring time is followed by a harvest of con- 
sumption in the summer and fall. Negroes seem to 
hAve no resistance to tubercular infection. They die, 
almost without exception, within from six to twelve 
months after the initial invasion, and no plan of treat- 
ment has even a palliative effect. Pneumonia is not 
especially prevalent, but is not rare. A few cases occur 
in the various parts of the county every winter and 
spring, with here and there an occasional epidemic. 
These epidemics appear, at times, to have a very strong 
element of infectiousness. Upwards of 150 cases of 
pneumonia have been treated by the doctors in the town 
of Talladega, and, possibly, not two dozen cases outside 
of this locality. Whether the tendency is due to local 
conditions, or whether the contagious principle is the 
deciding factor, the data at hand do not justify an opin- 
ion. It is not the fatal disease with us that statistics 



426 CLIMATIC EFFECTS IN TALLADEGA COUVTT. 

show it to be in other quarters. The death-rate for the 
county^ according to the best statistics attainable, is leBs 
than ten per cent. 

Acute bronchitis and follicular tonsillitis seem to 
bear very close clinical relationship. They are exceed- 
ingly common troubles, rarely ever kill anybody, but 
persistently refuse to entirely subside. They are almost 
always accompanied or followed by rheumatism, in 
some form, and the writer thinks it probable that the 
three troubles are nothing more than varieties of a 
common pathological condition not yet understood. It 
has been noticed that these troubles are more pronounced 
during the variable climatic changes of spring-time, 
when the human economy is undergoing those metabolic 
changes which adjust it to a change of season. It is 
known that at such times the emunctories are taxed to 
their utmost power of elimination, and it is probable 
that the disturbance of the function of the skin over- 
taxes the kidneys, rendering them incapable of eliminat- 
ing their normal quantity of solids; which, being stored, 
find expression in sore points, inflamed tonsils, and a 
hundred other dyscraslas yet to be interpreted by the 
chemist and the miscroscopist. 

This observation is accentuated by recent observa- 
tions as to the whole quantity of urine passed in twenty- 
four hours by patients suffering from these troubles. 
Scanty urine was found to be a constant symptom, and 
every case began to improve immediately upon restora- 
tion of the normal function of the kidneys. This is a 
question of especial interest, and very broad in its 
scope, and it is with regret that it is of necessity passed, 
with this casual reference. 

Nephritis, acute and chronic, is not infrequent, but is 
met with. It presents no features of peculiar interest. 
Kenal calculus is, however, very common. It is worthy 
of note that of the sixteen cases, the histories of which 
were collected, thirteen of the persons drank water from 
limestone springs, and three of them from the same 
spring. The remaining three of the thirteen were sup- 
plied by wells of similar quality. This observation is 
more striking, because spring water is the exception and 
not the rule. One of these cases had complete immunity 
from attacks while drinking free-stone water, a few 
springs of which are found in the mountainous regions. 



SAMUEL WALLACE WELCH. 427 

The stones met with have all been of the uric acid va- 
riety. 

It does not appear that bowel troubles differ from the 
same troubles elsewhere, but it has been noticed that 
such troubles are more asthenic and much harder to 
manage when there is a failure of the fruit crop. We 
have a record of one unusually fatal epidemic of dysen- 
tery during the spring of 1899, when there was no fruit. 
It was noticed, too, that the more violent expressions of 
the disease were confined to the negroes and the poor. 
The more opulent classes, who could command fruit 
during the winter, having more or less immunity. This 
scorbutic tendency was manifest during the whole of 
1899 and the early spring of 1900, when the epidemic of 
la grippe was attended with such an unusual degree of 
prostration. It was also noted that all troubles treated 
during this period responded promptly to the adminis- 
tration of lime juice, and bore with facility heroic doses 
of strychnine. 

Liver troubles are not unusual. Two epidemics of 
catarrhal jaundice, in the springs of 1896 and of 
1898, presented some very interesting features. The 
disease was so prevalent in certain localities as to sug- 
gest a specific infectious or contagious principle. No 
conclusions were reached on this point, however. Three 
puerperal women, who contracted the disease, aborted, 
and died with symptoms of yellow atrophy of the liver. 

Eipidemies of the zymotic troubles common to Ala- 
bama, occur. It is not Jbelieved that yellow fever can 
live in this climate. The records of three cases that oc- 
curred among refugees have been collected, all of whom 
died, without further development of the trouble. 

Diphtheria and scarlet fever have not been epidemic 
for some years, but we meet a case or two of one or the 
other every year. A number of cases of diphtheria have 
been recorded in the last few years, apparently of spon- 
taneous origin. The children were residents of the rural 
districts, and had not been away from home. The dis- 
ease would run a typical course, and no other member 
of the family contract the trouble. 

Childhood and infancy run the gauntlet of diseases 
incident to this i>eriod of life, but I do not know that 
they differ from like troubles elsewhere. Dr. B. B. 
Sims reported a case of infantile scorbutus in the spring 



I 



428 CLIMATIC SFMCTB IV TALLADBQA COUNTY. 

of 1900. He called attention to the rareneM of this 
trouble in the South, and pointed to the fact that chasg- 
ing social conditions might make it more common in 
the future, and, for like reasons, I direct your attention 
to it to-day. \ 

DISCUSSION. I 

Dr. I. J. Sellers — With reference to the family at 
Lock No. 4, the precautions taken in screening the 
house and boiling the water were sufficient to prevent 
malaria, and probably did so. The trouble was that 
th€ members of the family were not protected from mos- 
quitoes, when out of doors. 

With reference to two poisons existing at the same 
time in the same person, namely, typhoid and malarial 
organisms, I doubt it. The trouble is that the clinical 
symptoms sometimes resemble each other very closely, 
in fact, cannot be differentiated without the microscope. 
Had it been used in these cases, it is probable only one 
organism would have been found. 

My limited experience leads me to believe that we do 
not have both these diseases existing with well devdoped 
clinical features, in one person, at the same time. 

Dr . H . A . Moody : I consider this discussion moot 
business-like and useful. I wish to say, concern- 
ing the agency of the mosquito in disseminating ma- 
laria, that I am not in a position to deny to the festive 
anophele,s the power thus to spread the poison. But I 
am in a position to deny to him the sole agency. hBBt 
year, I made some observations on that point, and had 
the able assistance of some of my colleagues of this body. 
The gentleman who read the paper under discussion 
was one of the number. It took but a little while to se- 
cure the records of malarial outbreaks in April, malar- 
ial attacks of the winter-spring type, in placet where 
no mosquitoes had existed for four months. If tiiey 
lived over from the preceding season they must have 
lived from the preceding spring, as the attacks were 
not of the aestivo-autumnid character. 

I wish, too, to say a word about the blisters i^ken of 
as being used in pneumonia. By many they are derided 
as crude, cruel, and unnecessary. When I hear one 
abasing blisters in that way I reflect that not all blisters 



BAMUEh WALhAOM WWMB. 429 

are aUke, either in character^ management, or effect. 
Once, I wondered why people who haij been blistered 
^'ere so urgent to have them repeated whenever a pleuri- 
tic pain, with or without pneumonic inflammation, oc- 
curred. But now I know why. I had pneumonia myself, 
with the whole list of pathognomonic symptoms, and the 
relief from pain and oppression I experienced every time 
a blister drew over a painful spot fully explained the 
n:iatter. Dr. Eckley's paper explains the physiological 
reason. There is a direct and uninterrupted line of 
nerve communication between a spot on the surface and 
the viscera beneath it. So, both from theory and ex- 
perience, I believe in blisters, in proper cases. 

Dt. a. a. McKittrick — I rise merely to confirm Dr. 
Moody's statement as to the indication and utility of 
blistering in pneumonia. 

Long experience has demonstrated to my mind their 
efficacy. The old Hippocratic aphorism, ubi irritatio ibi 
flexus, may or may not be the true explanation. But, 
whoever can be convinced by observation and experience 
will be obliged to conclude that in proper cases blisters, 
properly applied and properly managed, are efficacious 
for good. 

Dr. W, H. Robertson — ^Lest, after the adjournment 
of this body, all those who are unfortunate enough to 
have pneumonia should be unmercifully blistered, I de- 
sire to say that an experience of fifteen years has fully 
coi)vinced me that blisters in pneumonia are not only 
useless, but positively harmful. During the first eight 
years of my professional life I frequently applied blis- 
ters in pneumonia, because others did it, and because 
I did not know how to deny my patients that abominable 
luxury that was accorded to their fellow sufferers. 

In 1893, I adopted the following treatment : Calomel, 
quinine, and dovers powders, with antikamnia and 
codeine, to control pain and fever. 

After the secretions have been aroused, I give strych- 
nine, digitalis, and whisky. I sometimes use turpen- 
tine, with hot fiannels or mustard, to redden up the 
chest, which is then covered with cotton batting, and 
a close fitting jacket of oiled silk, to protect it from 
changes in the temperature. This plan of treatment is 



430 CLIMATIC EFFECTS IN TALLADEGA COXINTT. 

practiced by Dr. L. Emmett Holt and Dp. Augast Sei- 
bert of New York. They are eminently snccessful ^with 
it in their hospitals and private practice. A favorite 
expression of Dr. Seibert is that "we get along beauti- 
fully with pneumonia when we let the pneumonia 
alone." 

My own experience with this plan of treatment has 
been entirely satisfactory, and much more successful 
than when I used blisters. After all these experiences 
and observations, I desire to record myself as unalter- 
ably opposed to blisters in pneumonia, as they are un- 
scientific and wholly unnecessary. 

Dr. Welch (closing) : In view of the surprise, to put it 
mildly, which all seem to share at the low death 
rate from pneumonia reported in this paper, allow me to 
say that I made the statement in all earnestness, after 
careful investigation of the facts; and what is true of 
Talladega county is true of the district contiguous to it. 

We do not claim more skill in handling this trouble 
than is possessed by our brethren, for quite frequently 
the treatment consists solely in good nursing and a 
placebo. Uncomplicated cases of pneumonia in pa- 
tients between the ages of five and forty-five years, will, 
as a rule, get well with no medicine at all, save what 
may be required to keep the bowels moving with suffi- 
cient regularity. With us, the disease lacks the fulminat- 
ing qualities seen in the colder latitude of Baltimore, 
and, we believe this is due to climatic effects. Our 
deaths from pneumonia are confined almost entirely to 
negroes, old people, and small children. It would seem 
that from some cause negroes do not bear well any sort 
of pulmonary trouble. 

In my remarks on diphtheria I used the word "spon- 
taneous" in the sense in which Dr. Osier uses it. There 
was no obvious or traceable cause for these cases. One 
patient had been confined to her bed three weeks with 
bowel trouble, when she developed diphtheria. With us, 
as elsewhere, the atmosphere may be infected with the 
bacilli, which found a favorable nidus for development 
in the throats of these little patients. Certainly in no 
case was there any direct contact with the disease, nor 
did any one of them communicate it to any other. 



GEORGE HBU8TI8 FONDE. 43 ^ 



THE MICROSCOPE IN THE HANDS OP THE GEN- 
ERAL PRACTITIONER. 



Bt Geoboe Heustib Fonde, M. D., Mobii^ Ala. 
Member of the Medical Association of the State of Alabama. 



Early and correct diagnosis of diseases, with a full 
understanding of their stages and progress, would un- 
doubtedly add more to the success of medicine than all 
the new drugs, appliances, and methods which general 
practitioners are so eager to grasp, and to which they 
are so constantly looking forward. 

Early diagnosis, with the oun^e of prevention, will 
always be worth more than the pound of cure. 

Scientific diagnosis is based upon a thorough survey 
of the patient, supplemented by a careful consideration 
of the various symptoms detailed, and by thorough physi- 
cal exploration. 

In addition to these, let us briefly consider the value 
of the microscope in the hands of the general practi- 
tioner when applied in some of the common affections 
which daily demand our attention. 

When the advantages gained by microscopical inv<*sti- 
gation are considered, it will be seen that this method 
of analyzing cases is an almost indispensible aid to the 
best understanding and most intelligent treatment of 
the great majority of the affections which we are con- 
stantly called upon to treat. 

In fact, it would be safe to say that there is no aflFec- 
tion, acute or chronic, in which the intelligent use of 
the microscope would not reveal valuable information 
as to the nature, progress, or severity, of the case, 
and as to the degree of damage resulting to the organs 
which eliminate the morbific elements of the disease. 

However, before recounting the advantages to be 
gained by the use of the microscope in the hands of the 
general practitioner, I will say that it can scarcely be 
expected that one engaged in a busy general practice 
would equip a laboratory with all necessary instru- 
ments and appliances for extensive investigation, nor 



432 MICROSCOPE IN HANDS OF PRACTITIONER. 

could he well spare the time to carry ont a complicated 
and tedions technique, if all the equipment were at 
hand ; yet, by far the most of the practical nses of the 
microscope in medicine are rapidly and easily ayailable 
without such elaborate equipment, or the expenditure 
of much time. 

The simpler examinations, which may be quickly 
made, would give the keynote to correct diagnosis and 
treatment, in a large number of cases. 

The clinical symptoms could be observed and weighed, 
in conjunction with the disclosures of the microscope. 

The positive or negative evidence furnished by flie 
microscope would often enable the practitioner to apply 
treatment more rationally, and estimate its efficacy 
more accurately, than would be possible without such 
information; the same evidence would also enable him 
to avoid much unnecessary and harmful medication. 

Cases which require for their investigation culture 
media, incubators, or inoculation of animals, are great- 
ly in the minority, in general practice, though culture 
media can be purchased, ready for use ; incubators can 
be improvised, even for such cases as demand cultures ; 
and tissues can be hardened, sections made and 
stained, without very great loss of time, or expensive 
equipment. 

When cases arise demanding more elaborate micro- 
scopical work than a general practitioner could under- 
take, it would be easy for him to refer them to some one 
who is fully equipped for such work. 

However, it is the object of this paper to outline the 
use of the microscope as an immediate clinical aid to the 
more scientific practice of medicine, believing that its 
comparatively rare employment in general practice is 
due to the impression of many that its intelligent use 
presents many difficulties and complications which it 
would require much preparation and time to overcome. 

I will, therefore, call attention particularly to the 
value of microscopical examinations of the fluid tissues 
and excreta, which are simplest, and of the most practi- 
cal advantage. 

In reciting cases, I shall only touch upon the points 
in each which bear upon this subject. 

A case presents the following clinical history: Car- 
buncle on neck, considerable rise of temperature, dis- 



GEORGE HEU8TI8 FONDE. 433 

tressed breathing, and pain on right side. Coughing, 
painful, followed by local chest symptoms of pneumonia ; 
expectoration of dark grumous sputa, very tenacious, at 
first, and becoming quite copious; fever, at first remit- 
tent, ranging from 100** P. to IDS'* F., becoming inter- 
mittent. CoUiquitive sweats at each fall of tempera- 
ture. Condition of patient causing considerable anx- 
iety. Question : Is it an inter-current lobar pneumonia, 
an inter-current tubercular abcess, a broncho-pneumonia 
of la grippe, or a metastatic focus from the carbuncle, 
and a developing pyaemia? Microscopical examination 
discloses infiuenza bacilli in great abundance, within 
the pus cells, particularly; absence of tubercular bacil- 
lus; absence of pneumococci or pyogenic organisms in 
sufficient quantity to excite suspicion, even, of them as 
the cause; quite a number of uric acid crystals were 
noted during the examination — an additional indication 
for treatment. 

Steady and rapid subsidence of symptoms followed the 
use of creasote and guaiacol. Patient suffered a re- 
lapse, with return of cough and same character of 
sputa. Again a microscopical examination was made, 
and showed large numbers of influenza bacilli. Con- 
tinuing the use of the guaiacol and creasote, the patient 
again steadily improved, and got out upon the street. 
Another worse relapse resulted. Examination by the 
miscroscope was repeatedly made, but no longer showed 
presence of influenza bacilli. Great quantity of bloody 
and muco-purulent expectoration persisted, as though 
coming from a cavity in the lungs, — the result, perhaps, 
of a chronic pneumonia from the gripi)e infection. 

We see that in this case examination by the micro- 
scope at once enables us to understand the case, and 
removes the suspicion of tuberculosis, of pysamia, etc. ; 
it discloses the direct cause, and also uric acid as a fac- 
tor in the bronchitic inflammation, complicating the 
case, for, it is reasonable to suppose that the uric acid 
Irritation aggravated the bronchitis, and, perhaps, in 
the beginning precipitated the grippe infection. 

Second case. Constant and severe pain in back, sore- 
ness of muscles of legs; shooting pain in heel and left 
leg, and pain in testicle; buttermilk-like flakes in the 
urine, when passed, and thick buttermilk-like de- 
posit, on standing; local points of tenderness in back. 

27 



434 MICROSCOPE TN HAyOS OF PRACTITIONER. 

Examination of urine by the microscope: myriads of 
crystals of tripple phosphates, sulphate and phosphate 
of lime; numerous crystals in casts were present, indi- 
cating the formation of the crystals in the uriniferoii» 
tubules; granular and hyaline casts in considerable 
number. Up to this time, had not considered the kid- 
neys as contributing to the pain in the lumbar region, 
nor had the patient's or my attention been drawn par- 
ticularly to them, by the symptoms, but after the ex- 
amination, and upon the hypothesis that the crystals 
forming in the uriniferous tubules would cause irrita- 
tion and congefetion of the kidneys, they were palpated, 
and found tender. Upon subsequent daily palpations, 
it was found that a marked degree of tenderness alter- 
nated from one kidney to the other ; on one morning the 
left would be decidedly the more tender, and on the next 
morning the right kidney would be so; reasoning fur- 
ther, on the same line, from the disclosures made, it was 
concluded that crystal deposits had occurred in the 
tender points in the muscles of the lumbar region, and 
this, also, accounted for the general muscular soreness. 
The patient being a great sufferer from obstinate chronic 
constipation, and indigestion, laxatives were freely 
given, and in addition a small dose of Rochelle salts 
every morning. Diet of buttermilk was ordered. Piper- 
azine, gr. xv per day in a liberal quantity of Donald 
or Stafford water. Cystogen gr. v twice a day. Urine 
immediately became perfectly clear and abundant ; ten- 
derness and other symptoms subsided ; casts became less 
abundant, but were present. Patient was put on a bit- 
ter tonic, which contained styrchnine and hydro- 
chloric acid, and was directed to take a trip. The 
symptoms in this case -were quite severe, and alarming 
to the patient, and to his family, so much so, that I was 
asked to call in consultation. The muscular pains in 
this case were first most complained of, and, later, 
nephralgia was the most marked symptom. The pa- 
tient being a male of 17 years, and, as the usual dis- 
turbances of the sexual organs at this age accompanied 
the trouble, or preceded it, there was great depression 
of spirits and a strong tendency to sexual hypochon- 
driasis. Patient followed directions, and was absent 
from the city for one week, but, feeling greatly relieved, 
he returned to resume work ; slight and persistent paiir 



i 



GEORGE HEU8TIS FONDE. 435 

in small of back again annoyed and alarmed him. Ex- 
amination by the microscope showed very numerous 
large and small crystals of oxalate of lime ; a very few 
granular casts, aud a few spermatozoa ; thus* enabling us 
to note that the faulty metabolism causing formation 
and precipitation of phosphates in excess had changed^ 
and produced another irritating crystal, but with the 
same metallic base; the first being the phosphate and 
sulphate of lime, with the tripple phosphates, and the 
last being oxalate of lime, and both being capable of 
producing kidney irritation, which, if not properly 
understood and corrected, might do permanent damage 
to the kidneys, or otherwise undermine the patient's 
health. We see that in this case the microscope could 
not have been well spared ; first, in watching the kidney 
secretion, to avert a chronic kidney lesion, for, as long 
as the kidneys throw^ oflf casts, etc., we should direct our 
patient's mode of life and medicinal regimen, in order to 
treat the case in the most scientific and satisfactory 
way; secondly, by finding absence of the microscopical 
elements which are present in renal calculus, in sexual 
disorders, etc., we were able to reassure our patient. 

Third. Two cases of acute nephritis. A microscopic 
examination of the urine made the diagnosis clear and 
positive early in the attack. The degree of severity of 
the cases was estimated by the relative number of renal 
cells, epithelial casts, and blood cells found. During 
the abatement of the trouble examinations were made^ 
from time to time, so that a proper regimen might be 
ordered, and the progress toward recovery guarded. In 
both these cases uric acid crystals were discovered in 
comparatively fresh urine after treatment was omitted^ 
and patients were out on the street before disappear- 
ance of casts, — thus giving an indication for treatment 
that might have retarded recovery, if overlooked, or 
might have resulted in producing a chronic nephritis^ 
or a relapse. One of these cases has never ceased to 
throw off casts, both granular and hyaline, though the 
case developed suddenly and showed bloody urine near- 
ly a year ago. This patient ivas a heavy and regular 
drinker up to the onset of this attack, but upon my ad- 
vice stopped off altogether. It is unnecessary to em- 
phasize the importance of the information furnished by 
the microscope in these cases, and impossible to over- 



436 MICROSCOPE IxV HANDS OF PRACTITITIONER. 

estimate its value in promating the welfare of the pa- 
tients. 

Fourth. A case presenting the following symptoms : 
Vertigo, somnolence, irritation and stiffening of the 
carpo-phalangeal and metacarpo-phalangeal joints, gen- 
eral depression, synovitis of a large joint, with hydrar- 
throsis and a bronchitis. Urine showed, microscopical- 
ly, very large deposit of brick-dust sediment; crystals 
of uric acid, large enough to be seen with the naked eye. 
Kidneys suspected as the source of trouble. Examina- 
tion by the microscope disclosed very large and very 
abundant uric acid crystals; casts filled with numerous 
crystals of uric acid; numerous leucocytes, evenly dis- 
tributed, for the most part, therefore, probably from a 
catharrhal pyelitis, or exudation from the irritated 
tubules ; granular and hyaline casts. Oonclusion : uric 
acidsBmia, from faulty tissue metabolism. Anti-uric 
acid treatment brought about marked improvement in 
the microscopical showings, and casts and crystals 
gradually disappeared. Patient recovered. 

Fifth : Another case of grippe. Girl of 18 ; very deli- 
cate; had a sand-spur removed from larynx seven or 
eight years ago, which left chronic thickening of the 
vocal cords, or a cicatrix, which has ever since caused 
husky voice. Family already anxious about her. Had 
been feeling badly for several days before being seized 
with an attack resembling grippe; high fever; painful 
cough, and spitting of blood-tinged muco-purulent ma- 
terial. Family concluded that the trouble was tubercu- 
losis, and the patient thought herself doomed. 

Microscopical examination showed presence of nu- 
merous small influenza bacilli, within the pus cells, par- 
ticularly ; absence of tubercular bacilli. The advantage 
given by the microscope is evident. Liquid beef pepton- 
oids, with creasote and guaiacol, combined with emul- 
sion of petroleum and hypophosphites ; steam atomizer 
for inhalation of formalid (which contains formalde- 
hyde and some of the volatile oils), and decided doses of 
strychnine with wine, resulted in rapid convalescence. 

Sixth case: Stricture from a gonorrhoea of twelve 
years ago. Patient gave history of frequent urination 
in the day, with all the accompanying symptoms of 
stricture, such as pain in the back, from renal conges- 
tion, headache, and the passage of urine tinged with 



GEORGE HEVBTIB FONDE. 437 

bloody and bloody urine trickling on underwear after 
micturition. Microscopical examination showed blood 
and pus in urine, together with granular casts. Oradual 
dilatation was practiced, and patient slowly recovered. 
Was enabled to determine the condition of the kidneys, 
from time to time, by microscopical showings, and to 
properly direct the mode of life and treatment, until the 
kidneys fully recuperated. 

Seventh case: One of pulmonary tuberculosis. Pa- 
tient had consulted a physician sometime before, and had 
been placed upon creasote in gradually increasing 
doses, and was told to take as high as forty drops three 
times a day until it commenced to disagree with him^ 
then to change to carbonate of guaiacol. The creasote 
had been taken in large doses in milk for sometime, and, 
when I was called in, patient was taking the carbonate 
of guaiacol, without weighing it. He purchased it in 
bulk, and measured it in liberal doses. Patient pre- 
sented every symptom of an acute nephritis from chemi- 
cal irritation ; bloody, scanty urine, pain in back, oedema, 
etc. Patient got out again after a long time, and died 
out West. This was a well advanced case of pulmonary 
tuberculosis, but I relate it as an instance in which 
occasional microscopical examination might have 
averted a grave complication. Doubtless, it would be 
wise to watch the kidneys carefully whenever any remedy 
is being pushed to the maximum dosage, or when it is 
prolonged for a considerable time. 

Without further relation of cases, and in order to con- 
sume less time in the consideration of the uses and value 
of the microscope to the general practitioner, I select 
the following list of conditions and diseases in which the 
microscope can be most readily applied ; the list is made 
from Saunders's Medical Hand Atlas of Internal Medi- 
cine and Clinical Diagnosis, by Jacob, in which book 
are microscopical illustrations in colored plates to 
serve as a guide. 

Microscopy of the mouth and nasal cavities : Thrush 
fungus, spirochetsB of gangrenous stomatitis, diphtheria 
bacilli, etc. 

Microscopy of Sputum : In asthma, in abcess of lung^ 
in gangrene of lung, pneumococci in pneumonia, sputum 
from case of tubercular infection, from influenza infec- 
tion, from actinomycosis infection of lunt;. 



438 MICROSCOPE IN HANDS OF PRACTITIONER, 

Microscopy of contents of stomach and intestines: 
Intestinal contents and infections, from cases of chol- 
era nostras, from asiatic cholera, infections by amoeba 
coli, etc., etc., ova of the following worms; oxyuris, 
trichocephalufi, taenia saginata, t»nia solium. 

Microscopy of urine: The numerous crystals which 
have important significance in determining certain con- 
ditions, or metabolic errors, epithelia from bladder, pel- 
vis of kidney, renal cells, pus cells from kidney differ- 
entiated from those from bladder and below, by their 
distribution, blood cells, spermatozoa, casts of different 
varieties of kidney lesions. Tabarcular, gonorrhoaal, 
and other infections of the genito-urinary tract. 

Microscopy of the contents of cysts, abcesses, etc.: 
Crystals of uric acid from gouty nodule, which became 
cystic, echinococcus fluid, showing booklets. 

Pyogenic micro-organisms: Staphylococcus, strepto- 
coccus, bacterium coli communis, proteus vulgaris, 
bacillus of glanders, typhoid bacillus, etc., etc. 

To this list, and these uses, might be added Widal's 
test, and other tests, made with the microscope. Also 
the determination of bubonic plague and yellow fever. 

A good microscope, a book on pathological technique, 
and an atlas of colored microscopical illustrations, as 
guides, should enable even the busy general practitioner 
to add much to his thoroughness and his diagnostic 
ability. 

DISCUSSION. 

Dr. E. A. Jones : I thank Dr. Fonde for his excellent 
paper. Every practitioner can and should learn to use 
the microscope^ and such an instrument should be an 
indispensable part of the oflSce equipment of a doctor. 

Dr. H. A. Moody : I think the author should be con- 
gratulated upon his paper. The microscope enables us 
to know what without it we could only guess. Many of 
our older colleagues shrink from undertaking the study 
of bacteriologj% Even in such a case they should be 
armed with a microscope, leaving out the oil immersion 
lens, with its formidable looking accessories. An instru- 
ment with one-sixth dry objectice is cheap, simple, and 
will do blood and leucocyte counting, and all urinary, 
and most tissue work. That would be a long step for- 



GEORGE HEUSTI8 FONDE. 439 

ward for many of us, and the rest would soon follow. 
I do not wish to be understood as deprecating the high- 
er powers. For malarial parasites and bacteria they 
are indispensable. But, half a loaf is better than no 
bread, and for the timid and impecunious, the dry ob- 
jectives of moderate power will suit very well, and do 
immense service. 

Dr. E. C. Parker: I have listened to the paper with 
much interest, and appreciate the value of its suggest- 
ions. No man should engage in the practice of medi- 
cine without owning a microscope, and knowing how to 
use it. Without being a bacteriologist, a doctor can 
make the microscope of great assistance to himself and 
of great practical value to his patients. 



AXIS-TRACTION FORCEPS. 



Bt John Perkins Fubniss, M. D., Sexma, Ala. 
Grand Senior Life Counsellor of the Medical Association of the State 



For twenty years I have served as a member of the 
County Board of Medical Examiners, in charge of the 
branches of mechanism of labor and obstetric opera- 
tions, and as a member of the State Board of Medical 
Examiners, in charge of the branch, mechanism of labor, 
for the past four years. 

One of my duties, as a member of the State Board, is 
to review such portions of the work of the county boards 
as may be assigned me by the Senior Censor. 

I have been impressed by the fact that not in a single 
instance has a preference been accorded the axis-traction 
forceps in any obstetrical condition. 

I have, in times past, been in correspondence with 
eminent physicians at the centers of medical teaching, 
with a view to ascertaining the reason of the want of 
popularity of w^hat appeared to me to be a most valu- 



440 AXJS'TRACTION FORCEPB. 

able appliance. Some replied that they considered the 
axis-traction forceps complicated and unnecessary, and 
that the conditions for which it was claimed that it waa 
particularly adapted, could be better met and relieved 
by other procedures. For instance, for all conditions 
requiring delivery, where the foetus was above the 
brim, the operation of safety, and election, was version. 
Others replied that all medium and low operations could 
be accomplished as well, if not better, by the classical 
forceps, and that this is particularly the case in medium, 
operations where Pajot's manoeuvre is all that can be 
desired. 

Another eminent practitioner and teacher admitted 
that there were conditions where the axis-traction for- 
ceps was indicated, though they were rare. He said 
that, while many thought the instrument an obstetrical 
luxury, he believed the satisfaction the practitioner 
felt in having it in his possession was like that of a man 
in Texas or other frontier, who because he was there 
did not need a pistol, but when he did want it, he needed 
it badly. 

In late text books, Jewett is more partial than any 
other I know of to this modification of the forceps. He 
devised one of his own, which he thinks obviates many 
of the objections to the Tarnier instrument, and em- 
bodies many excellent features. 

He summarizes the sui)eriority of the axis-traction 
forceps thus : First : "Pulling, as it does, directly in the 
line of descent, all the tractile force is utilized. 

Second : "The blades being free to follow the natural 
movements of the head, the normal mechanism is not 
disturbed." 

Dr. Simon Marx, of New York, has done more by con- 
tributions to periodical literature to call attention to 
the advantages of the instrument and improvements in 
the technique of its application and use than any one 
with Tvhose writings I am acquainted. 

He has had a very extensive experience in the use 
of the Tarnier instrument, and claims that he is in a 
position to call attention to its great scientific value. He 
considers its use the remedy in posterior positions of 
the head, whether of the occiput or chin, and that rota- 
tion can be assisted and expedited by it without injury 
to either mother or child. 






JOHN PERKINS FURNIS8. 44I 

I cannot say that my experience has been very exten- 
sive, but it has been equal to that of the majority of 
general practitioners. 

For the past twelve years, whether in consultation or 
in personal practice, I have not used any other than the 
Tamier, or some form of axis-traction forceps, except 
on two occasions, in one of which I had the most exten- 
sive lesion I have encountered. 

I have time and again easily and safely effected de- 
livery with one hand by the use of axis-traction forceps, 
where all the force it was considered safe to employ had 
been tried and failed to produce any result. 

If it is true that, in the hands of a skilled operator^ 
the ordinary forceps does not interfere with the natural 
movements of the head, then I confess that I have not 
attained the proficiency to place me in that class. 

As a rule, no one can do good work of any kind unless 
he is accustomed to and familiar with the appliances 
employed. 

The original instrument of Tamier was unnecessarily 
large and heavy, and to some it appeared complicated. 
It has subsequently been modified and improved, and 
experience and familiarity with it will soon remove the 
objection of being complicated. 

Having used the ordinary forceps the first twenty 
years of practice, and, in view of the favorable results 
obtained with the axis-traction forceps during the past 
fifteen years, I feel impelled to state my belief that the 
use of the latter constitutes as great an epoch in obstet- 
ric surgery as did the introduction of the original in- 
strument by Chamberlain. 



442 GRANULATION AND 8KIN GRAFTING. 



HEALING BY GRANULATION AND SKIN 

GRAFTING. 



Bt Oeobob Summers Bbowk, M. D., Bibminghasc 
Senior Counsellor of the Medical Association of the State of Alabama. 



In considering the subject of healing by granulation 
it is obviously necessary to recall briefly the histology 
of the skin. 

The skin consiists of two principal layers : — the siiper- 
flcial or epithelial which is derived from the epiblaFt, 
and the deep layer or true skin which is derived from 
the mesoblast. The epithelial layer is made uji of a 
superficial or corneous layer, called the Stratum Cor- 
neum, next a clear narrow streak the Stratum Lucidum, 
the Stratum Granulosum and the Stratum Mucosum 
or Rete Malpighii. Practically the skin consists of 
three layers: — first the corneous layer or cuticle, the 
dry scaly surface which is supplied with neither blood- 
vessels nor nerves; second the Rete Malpighii which is 
from one to five times thicker than the first and is the 
deeper, more actively functionating of the ephithelial 
layers, and rests upon and is intimately connected with 
the third, the Derma or true skin. These last send pro- 
longations into each other in such a manner as to be 
really inseparable. The Rete consists of active living 
cells which are constantly multiplying and pushing the 
older ones towards the surface to become the lifeless 
cells of the cuticle. When a part of these cells are des- 
troyed those remaining grow new ones to fill the place 
The Derma or true skin consists of connective cells and 
stroma, white and yellow elastic fibrous tissue and 
muscle. When a part of it is destroyed it is replaced 
by white fibrous or scar tissue and never by anything 
else. 

Healing by granulation follows in wounds in which 
there has been loss of substance, usually of the soft tis- 
sues. Death of a portion of the skin and underlying 
tissues is usually quickly followed by infection and sepa- 
ration of the dead portion, with accompanying inflam- 



%• 



GEORGE SUMMERS BROWN. 443 

mation of the eontigaoas live tissue. When the dead 
jportion has separated granulations spring up and 
the inflammation in a great measure subsides^ though 
there is still an active warfare waged at the surface of 
the granulations between the leucocytes and the infect- 
ing germ. Beneath the surface, and seemingly stimu- 
lated thereto by the mild infection present, the connect- 
ive tissue cells proliferate and form fibro-blasts and 
new capillaries. As the granulations mount higher and 
higher, the deeper of these flbro-blasts are gradually 
converted into white fibrous tissue. This white fibrous 
tissue knows but one law, and that is to contract. It is 
nature's principal healing agent. The belief is not un- 
common that the edges of a wound through the activity 
of the epithelium gradually grow out, and ultimately 
cover the wound ; and, indeed, this was certainly Rever- 
din's idea when he said that only the epithelium was of 
any use in skin grafting. But the fact is that the epi- 
thelium has a very limited power to reproduce itself, as 
any one can observe by watching the progress of the 
healing of an ulcer. He will see that the looser the skin 
is surrounding the ulcer, the quicker it will heal, be- 
cause the skin will be the more easily drawn over it by 
the steadily contracting fibrous tissue beneath the 
granulations; he will also see that the blue line of the 
growing epithelium, after reaching a width of say a 
third of an inch, does not grow any more, but only 
seems to on account of the steadily diminishing size of 
the ulcer. This contraction of the firous tissue is aided 
very much by the very common practice of pulling the 
edges of the ulcer toward each other, by means of strips 
of adhesive plaster. This process is shown clearly in 
an amputation stump, where the fiaps have sloughed, 
and left a granulating surface the size of the end of the 
stump. When this has healed, a linear scar is the re- 
sult, and the stump is covered with not new skin, but 
healthy, normal, old skin, which has been pulled down 
from above by the contracting fibrous tissue beneath 
the granulations. When the ulcer is situated in a part 
where the skin is unyielding, the fibrous tissue cannot 
draw the skin over it, and it must remain chronic. 
Such an ulcer remains flat and glazed, and does not 
show lively, healthy granulations, because it has be- 
come so full of scar tissue that its blood supply is defl- 



444 QRANVLATJON AJfD SKIN GRAFTING. 

cient. Frequently it has remained long enough for a 
nerve supply to have developed in it, and then we have 
the unhealthy granulations sloughing away from time to 
time, and leaving these nerve filaments exposed, con- 
stituting an irritable ulcer. A bed sore over the sac- 
rum or heel are common examples of chronic ulcers^ 
owing to this unyielding nature of the skin in those 
situations. I have recently seen a very fine example of 
it in a crushing amputation of a great toe. The patient 
was a large negro man, and the toe sloughed at the me- 
tatarsal joint, leaving a very large ulcer, dependent for 
healing on the contracting scar tissue being able to 
pull together the thick skin of the sole and the tough 
parchment-like skin of the dorsum of the foot, which 
was only less thick than that of the sole. He would not 
have it skin-grafted, and the result was it took more 
than six months to heal. 

While, then, the epithelium of the edges of an ulcer 
grows, to a limited extent, in its effort to heal the de- 
fect, the true skin does not grow at all, but is put upon 
the stretch and drawn over the ulcer by the contracting 
fibrous tissue. After the ulcer has healed, the skin 
around it, which has been on the stretch for so long, 
will be found to become more and more lax, and in 
time, will have resumed its normal texture. This shows 
that although the true skin does not grow from its edge, 
it does, when put upon the stretch, grow in its continu- 
ity by a process of hyperplasia, which answers the re- 
quirements for healing quite as well. This increase 
in the amount of skin by a process of hyperplasia, is well 
seen in all plastic operations, E. Q. When the lower 
lip is removed for cancer or from trauma, and the skin 
of both jaws is slid down and brought together to make 
a new lip, at the completion of the operation the skin 
will be very tight in some places and puckered in 
others ; but in a few weeks it will have become smoothed 
out, lax and pliable. 

In wounds where, from any cause, contraction cannot 
take place, and in wounds where its occurrence threat- 
ens to result in deformity, and where scars have al- 
ready resulted in deformity, we have a very efficient 
remedy in skin-grafting. 

fieverdin, in 1869, was the first to read a paper on 
the subject of skin-grafting, and thereby established 



GEORGE SUMMERS BROWN. 445 

the operation on a sound, scientific basis, though there 
have been found occasional references to such proced- 
ures as far back as the time of Galen. Notable among 
these historic curiosities are the spur of a cock, which 
was grafted on to his comb, where it is said to have 
flourished with more vigor than before; the nose that 
was slashed off in a duel, and which, after having been 
recovered from a dog that had run off with it, was 
^stitched back in its accustomed place with more or less 
accuracy, and afterward thrived prodigiously; and the 
case of the surgeon priest, w^ho, in treating a poor sol- 
•dier who had lost a large osteo-plastic flap from the top 
of his head, skillfully transferred a like flap from the 
head of a. dog to supply the defect. We conclude that 
this operation was eminently successful from the further 
information that the fathers of the church, in fear of 
the consequences of such anatomical misc^enation in 
the world to come, particularly to those Who permitted 
it, ordered the enthusiastic surgeon to perform a second 
-operation and undo his unholy work. The after history 
of this case, like all the fragments rescued from the 
twilight of tradition, is imperfect, and we really have 
nothing reliable on the subject prior to the classical 
paper of Reverdin in 1869. It has been claimed that 
Dr. Frank Hamilton, of New York, flrst suggested, in 
1847, and performed in 1854, the operation of skin- 
grafting; but it is more than probable that he merely 
did an autoplasty; that is, he transplanted a flap with 
a pedicle from one leg to an ulcer on the other without 
any thought of its growing in true graft fashion over a 
wider area than it covered at flrst. At any rate Rever- 
din has all the credit, as he should have it, who flrst 
successfully promulgates a discovery. Reverdin's dis- 
covery that islands of epithelium sprang up where 
small particles of cuticle had accidentally fallen on a 
granulating surface, was the all-important one, and his 
method of operating was in exact imitation of this pro- 
cess. He said positively that the epithelium was the 
only part of the skin that could be useful for grafting ; 
but this is now known to be very largely erroneous. 
Oilier, in 1872, began using pieces of the whole thick- 
ness of the skin of from a fourth of an inh to one inch 
in diameter; and in 1875 Wolfe, of Glasgow, conceived 
the idea (and carried it out) of covering a skin defect 



^ 



446 GRAIfULATION AND SKIN GRAFTING. 

with a piece of the normal^ full thickness of the skin 
large enough to cover it. Thus many quickly recog- 
nized that the epithelium was not sufficient of itself to 
give good results. Then in a little while came Thiersch's 
discovery, which now answers almost every demand 
that is made in this field of surgery. There has been 
quite a large field of experimental research worked 
over since Keverdin's discovery in 1869, but I had 
neither the data nor the time and space to review it at 
all fully in this paper. The field comprehends manj 
experiments upon the lower animals, and still more, 
perhaps, upon the patients of the experimenters; these 
include grafting and transplanting of almost every 
known form of epithelium and skin, such as E. G. dead 
epithelial flakes, like those Reverdin first observed 
growing accidentally upon granulating surfaces; then 
followed snippings of the skin, which were planted arti- 
ficially in imitation of the first; these doubtless were 
more satisfactory, as in many instances they must have 
included a part of. the true skin. Pieces of the skin of 
blisters, frog's skin, and the lining of egg shells, have 
been used, all doubtless with some degree of success. 
The Thiersch method is to shave off a part of the skin- 
thickness, say about one-half, cut in strips, and put on 
enough to entirely cover the defect. This, therefore, is 
not a graft in the sense that Keverdin meant, but a 
transplantation. Ollier's method is true grafting. Al- 
though he used pieces of the full thickness of the skin, 
he put them on expecting them to grow and cover the 
spaces he left uncovered. The Thiersch graft, however, 
is a term that has come to stay, and I have no desire 
whatever to suggest a change, if for no other reason 
than that it is really a graft, even if not in the sense 
Reverdin meant. 

When this graft is cut the projections of the Rete 
Mucosa, which go down between the papillse of the cor- 
ium, are cut across and the deeper portions of them are 
left, from which new epithelium springs and covers 
the surface of the true skin remaining, thereby avoiding 
the contracting scar that always follows when the en- 
tire thickness of the skin has been removed. There are 
a few exceptions wherein the Wolfe method of trans- 
porting the whole thickness of the skin is best, as, for 
instance, the palm, or the chest wall, or other places 



• > * 



llralin'T by Ciraniilation. 



GEORGE aVMMERB BROWN. 447 

where the graft is to lie directly on the i)erio8teum* 
The photograph here represents an instance of the kind. 
The young lady, whose hand is shown, had it caught in 
an ironing machine about two years ago, and sustained 
a very severe burn and crush, which, healing by granu- 
lation, resulted in a bad deformity that rendered her 
band practically useless. Six months after it had heal- 
ed I removed a piece of skin from the thigh and stitched 
it into the defect left in the palm after the scar had 
been removed, and the hand spread out. This defect 
was oval in shape, and two by three inches in extent, 
and crater like in depth, so that in order to make the 
transported flap stay in place at all I was compelled 
to go against the advice of all those who have advocated 
the operation, and fasten it in place with sutures. This 
I had no occasion to regret, as every suture held, and 
not one suppurated, and the result was perfect as far 
as the grafting was concerned. As none of these writ- 
ers have given a reason for not using sutures, and as 
all such flaps can certainly be kept in place better with 
them than without, I am inclined to surmise that the ob- 
jection to them is more imaginary than real, and may 
be based merely on a fear of keeping the detached flap 
too long exposed. A few minutes cannot possibly make 
any difference in the vitality of the flap, as it has been 
demonstrated experimentally that such pieces of skin 
may be preserved for days and weeks without suffering 
any apparent harm. The Wolfe method is much less 
likely to be followed by adhesions of the flap to the 
underlying periosteum than is the Thiersch method. In 
fact, the latter method is almost always followed by 
such adhesions, which became free only after weeks or 
months, and sometimes never. The Wolfe method is 
always free from the first, as Oilier claimed was the 
case with his small grafts of the entire thickness of the 
skin, to which, as I have said, he first called attention in 
1872. 

All flaps of this kind should be carefully dissected 
off entirely free from fat. It will be recalled that prac- 
tically all the blood vessels of the skin proper run in a 
vertical direction, so that it derives its blood supply 
from the parts immediately beneath ; hence when a flap 
is transplanted it is much more necessaiy that it should 
lie in close apposition to the parts beneath than that 



448 GRANULATION AND 8KIN GRAFTING. 

it should be attached to the healthy skin by a pedicle. 
Indeed, it is very doubtful if a pedicle is of the slightest 
1)eneflt in keeping a flap alive. When a flap is to de- 
rive its blood supply from a pedicle the subcutaneous 
fat should be dissected up with it. This is well demon- 
strated in the rather recent oi)eration for making a 
new nose. In this operation a deep flap of skin and the 
underlying fat is dissected from the front of the arm, 
and left attached by a broad pedicle. This flap is then 
covered on its raw surface with Thiersch grafts, and 
allowed to heal. After a week or so this manufactured 
I)endent organ is used to make the nose. I beg, finallyi 
to call your attention to a point that has suggested it- 
self to me, relative to the process of the growth of skin- 
grafts, which I have not seen alluded to by any of the 
writers on this subject. We agree, I will suppose, that 
«kin put upon the stretch, and sutured so, will, in a 
short time, be found to have amplified and become lax ; 
and again, that ulcers do heal by drawing the skin from 
the surrounding parts, and leave only a linear cicatrix 
and this without the aid of grafting or adhesive strips. 
It has occurred to me from a contemplation of these 
facts, that when, for instance, an Oilier graft of the 
full thickness of the skin is placed upon a granulating 
surface, and grows, it does so in the manner I have tried 
to show in the diagram. Imagine a healthy granulating 
surface upon which two skin grafts are growing, one, the 
epithelial graft of Reverdin, and the other the graft 
according to Oilier, consisting of the full thickness of 
the skin. The second graft sends out its blue line of 
new epithelial growth at the surface, and at the same 
time the connective tissue elements of the derma, or 
true skin, anchor themselves among the flbro-blasts, 
and deep fibrous tissue of the granulations. This makes 
an island in this sea of contracting currents, and the 
contractions which formerly set from shore to shore, 
tending to draw the edges of the ulcer toward each 
other, now set from the edge of the ulcer to the edge of 
the island, and tend to draw these toward each other; 
the result being that the edges of the island are pulled 
upon from every direction by this .undertow of con- 
traction, and the island graft grows by being put ui>on 
the stretch and a consequent hyperplasia of the cells 
of the interior. While this is going on beneath the sur< 



GEORGE BUMMERS BROWN. 449 

face^ the epithelial border of the island is making a 
great show of covering the ulcer. The deception is 
complete, because we see that the edges have grown 
some without doubt, and the graft is undeniably larger. 
We will see, however, if we take some land-mark near 
the edge of the ulcer to go by, that the blue line of new 
growth rarely ever gets beyond a third of an inch in 
depth, and yet the ulcer steadily grows smaller. Re- 
curring to the consideration of the Reverdin graft, 
which was intended to be wholly epithelial, it seems to 
me that those that took successfully and grew were 
most probably not altogether epithelial, but con- 
tained a portion of the derma which was capable of 
forming a permanent connection with the scar tissue 
beneath. Before the advent of the Thiersch graft I have 
observed many times, after grafting a large surface 
with many small snippings after the Reverdin method, 
that some of them would grow, but that many of them 
after attaining the size of dime or less, would fall off 
in a most unaccountable manner. This I know was 
usually attributed to unhealthy granulations and infec- 
tion ; but I believe, in the absence of any better expla- 
nation, that these are purely epithelial grafts, and that 
they fall off because they have no means of forming 
fibrous tissue and becoming permanently anchored to 
the contracting scar with which nature remedies all de- 
fects in connective tissue, the reproductive power of 
epithelium being limited to a reproduction of cells of 
its own kind. 

Addendum — Since finishing this paper, two weeks 
ago, I have had another very interesting case of graft- 
ing, which I shall report briefiy. Miss Z., aged 42, ten 
years ago, sustained a simple fracture of the tibia, and 
did not get a very straight leg as a result, though she 
had surgical attention. Two years ago the 1^ became 
painful and, she thinks, became gradually more bent, 
until, when she applied to me eight months ago, it was 
very much deformed, and of no use to speak of, as the 
heel was drawn up, and she could put very little weight 
on it. In July last I resected both bones of the leg, 
straightened it, and fastened it with a silver plate and 
screws. The bone was very soft where it was cut 
through, and when, for some reason, the skin wound 

28 



450 ^^^ WIDAL REACTION. 

broke down, one of the screw holes became infected. 
Union took place promptly in the bone, but this screw 
hole, gradually, in the course of several months, became 
lai^er. This was caused, in part, by repeated cnrret- 
tiuK, done in the effort to make it heal. After exhaustr 
ing all means at hand, I determined to skin-graft it 
This I did eight days ago in the following manner: 
The bone cavity was as thoroughly cleaned out and dis- 
infected as was possible, and then a flap, oval in shape, 
and one by one and a half inches in dimensions, was 
taken from the inner side of the thigh where the skin 
is thin and free from hair. This flap was then sntured 
to the skin around the hole, or rather at its four sides, 
and was then packed as smoothly as possible into the 
bone cavity, which was rather irregular in shape. This 
was dressed dry and left for flve days. The condition 
then, and at the dressing two days later, seemed to be 
that the graft had taken well. The epithelium was 
macerated and coming away, as it seems to do always 
unless it can be kept perfectly dry, which, in this case, 
it could not be. I have never seen this operation allud- 
ed to anywhere that I remember except in a recent let- 
ter from my friend. Dr. Da C!osta of Philadelphia. 



THE WIDAL REACTION. 



Bt Bdoab Allen Jonbs, A. B., M. D., Bibminoham. 
Member of the Medical Association of the State of Alabama. 



To the person who studies the mechanism, as it 
were, of immunity, immunization, and cure, in infec- 
tious diseases, nothing is more interesting than the 
consideration of those substances occurring within the 
bodily fluids of immune animals, which are included by 
Behring under the term "anti-bodies." The mo»t im- 
portant of these, according to Levy and Kemperer 
(1), are: 



EDGAR ALLEN JONES, 45I 

1. Alexins (Buchner) — Bactericidal substances. 

2. Lysins (Pfeiffer) — Lysogenic substances. 

3. Agglutinins (Gruber) — Agglutinating substan- 

ces. 

4. Antitoxins. 

Gruber discovered that in the blood-serum of animals 
immune to cholera, typhoid fever, coli-infection, etc., 
there was a substance which was capable of causing the 
clumping — agglutination — of the bacteria causing the 
disease, when the serum and the bacteria were brought 
into contact. Widal applied Gruber's discovery, which 
had been used only as an interesting laboratory experi- 
ment, to the diagnosis of typhoid infection, and to him 
we are indebted for one of the most important discover- 
ies of modern clinical diagnosis. 

Dr. Wyatt Johnston, of Canada, has done a large 
amount of original work in America with this reaction, 
so that now his name is frequently associated with 
Widal and Gruber in the discussion of the subject. 

The time at which the reaction develops is one of the 
most important points to be considered in arriving at a 
knowledge of its value. Widal and Sicard (2) hold 
that the reaction usually occurs on the first day of in- 
fection, but the statistics of other observers that I have 
consulted do not agree with this statement. Of 219 
cases giving positive reactions out of 230 cases examin- 
ed by McFarland and Anders (3), 128 gave the reac- 
tion prior to the appearance of the rose spots, or before 
the eighth day of the disease ; 36 reacted during the sec- 
ond week ; 45 between the seventeenth and twenty-first 
day of the disease ; eight not until the twenty-fifth day ; 
and two as late as the twenty-eighth day. ( It must be 
noted, however, that in some of these cases the blood 
was not examined until the day mentioned, so that the 
reaction might have been present much earlier than it 
is shown in the statistics). Eohler (4) examined 62 
cases. The earliest reaction was noted on the third 
day. Three of his cases did not show the reaction until 
the ninety-seventh day. Cave (5) reports the reaction 
in relai>ses as being intensely developed on the second 
day. 

Is the reaction specific, and is it present in every case 
of typhoid fever? Stengel and Kneass (6) have tabu- 
lated 2392 cases of typhoid fever, in which the reaction 



452 ^^^ WIDAL REACTIOy. 

was positive in 2,283, and negative in 109; also 1,387 
cases, non-typhoid, in which 22 reacted positively and 
1,365 negatively. The results show : 

Reactions in typhoid cases 95.5 per cent 

No reactions in non-typhoid cases 98 . 4 per cent. 

Ciorrect results in 96.5 per cent. 

Incorrect results in 3.5 per cent. 

A. C Abbot (7), in a collection of records of Widal 
reactions, carried out in 4,154 cases, found that the 
error had been 2.8 per cent. Cave (5) in a series of 32 
cases, reports the reaction present in every one. He 
has never obtained the reaction except in actual or re- 
cent typhoid. Horton-Smith (8) rei)ort8 the results 
of Widal examinations in 546 cases. In over 200 the 
subsequent course proved that they were not typhoid 
fever, and in only one of these was a positive reaction 
obtained. It was discovered after the death of this pa- 
tient, that she had had typhoid fever four months be- 
fore entering the hospital. Horton-Smith states that 
in about 3 per cent, of all his typhoid cases the reac- 
tion never appears, though he does not state the num- 
ber of tests made, nor the length of time his cases were 
observed. 

Persistence of the reaction. In a series of 30 cases 
examined by McFarland (3), the latest certainly posi- 
tive reaction occurred after 8 years. 

One objection, already mentioned, to the use of Wi- 
dal's reaction in typhoid fever, is that it sometimes 
occurs in cases which are undoubtedly not typhoid. 
The normal sera of various animals possess the agglu- 
tinative power in varying degrees of strength. The 
sera of some animals will agglutinate typhoid bacilli 
in a dilution of 1 :40. A few cases have been reported 
in which normal human serum has caused the reaction 
in as high a dilution as 1:10. Such cases as these, 
however, are exceptional. In all cases where the dilu- 
tion has been suflBiciently great, no such results are ob- 
tained. The technic is of great importance. The first 
point to be considered is the dilution of the serum. 
Nearly all reactions are now observed by means of the 
microscope, and only a small quantity of blood is re- 
quired for each examination. Many methods of col- 
lecting the blood and diluting it, or the serum, have 
been used. Some of them are: The collection of one 



EDGAR ALLEN J0NE8, 45g 

drop of blood on a piece of paper, or tinfoil, and al- 
lowing it to dry; collecting the blood in tubes and al- 
lowing it to coagulate and expel the serum; diluting 
the blood in a fresh condition with blood-eounting pipet, 
or variously devised pii)ets. The disadvantage of the 
dried-blood methods is the inaccuracy of the dilution, 
as it can at best be only approximately accurate. A 
serious fault with the dilution of the fresh blood is 
the presene of the orpuscles. A device which is quite 
simple, which was shown me by Dr. Lupton, of Johns 
Hopkins, avoids both of these troubles. It is easily 
made in a minute or two by any one who can get a 
suitable piece of glass tubing, and a bunsen flame, or 
alcohol lamp. The device furnishes a chamber in which 
the blood coagulates, a pipet to measure the serum from 
the coagulation chamber, and also a pipet for measuring 
the diluting fluid. The two pipets are of the same diame- 
ter, hence the drops of fluid which they make will be of 
the same volume. 

The culture should be young, and actively motile. It 
is best obtained by growth on agar-agar for 18 to 24 
hours. Older cultures will do if young ones are not 
available. 

The following is the technic followed by me and 
taught to my students: Take one loopful of the growth 
on agar-agar of 18 to 24 hours old typhoid culture, and 
distribute thoroughly in 10 to 15 drops of sterile bouil- 
lon in test tube or watch glass. Experience teaches 
just how much cloudiness of the bouillon is necessary 
in order to procure good separation of the bacilli. A 
hanging-drop of this mixture is now observed, to ascer- 
tain whether the germs are well distributed and active. 
The dilution of serum is the next step. First, one 
drop of serum is allowed to run from the coagu- 
lation chamber into a clean test tube, and four drops 
of clean Avater are added from the diluting pipet; this 
gives a dilution of 1 :5. One loopful of this serum-mix- 
ture is now added to one loopful of the bouillon mix- 
ture of bacilli, giving a dilution of the eerum of 1 :10 . 
This mixture is examined in hanging drop. Second, 
to the tube containing the serum diluted 1 :5, 20 drojjs 
of water are added, making a dilution of 1:25. One 
loopful of this is mixed with one loopful of the bouillon 
mixture of bacilli, giving a dilution of 1 :50. It is cus- 



454 ^^^ widaIj reaction. 

tomary to obseire the dilation of 1:10 for 15 to 20 
minutes; the higher dilation is observed for one hoar. 

In order that a positive reaction may be reported, it 
is necessary that tiie bacilli cease moving and aggluti- 
nate. Cessation of movement alone, or clamping alon^ 
justify only a "suggestive** report. 

It is the general concensus of opinion that the serum 
should be diluted at least 1 :40 or 1 :50. 

It seems probable that the reaction will never become 
very x)opular among physicians outside the hospitals or 
large cities affording clinical laboratories; for, while 
the technic is not difficult, it requires a certain amount 
of laboratory training, and also a fairly well equipped 
laboratory. 

I can do no better, in giving the conclusions as to 
the value of the Widal reaction in typhoid fever, than 
by quoting the deductions of McFarland and Anders: 

"1. The disease is not to be excluded on account of 
the abscAce of a positive Widal reaction, since genuine 
cases have been met with in which a negative result had 
been obtained throughout. 

"2. All cases that react positively are to be regarded 
as typhoid fever, until a thorough bacteriologic exami- 
nation fails to reveal typhoid bacilli anywhere in the 
body, as cases occur in which the usual enteric lesions 
are entirely wanting. 

"3. Taken singly, the sero-reaction is the most 
trustworthy indication of typhoid fever. 

"4. Although not an early diagnostic symptom, it 
nevertheless serves to complete the diagnosis in the 
great majority of cases at the earliest date possible. 

"5. Since the sero-reaction may be long delayed, and 
very exceptionally absent throughout, it cannot solely 
be relied upon for therapeutic purposes. 

"6. Previous attacks of typhoid fever within 1 or 2 to 
8 years, render the test valueless. 

"7. In order to secure accurate results, the technic 
is to be carried forward by a trained bacteriologist.** 

REFERENCES. 

1. Clinical Bacteriology, 1900. 

2. Pathogenic Bacteria, McFarland, III. Ed., 1900. 

3. Phila. Medical Journal^ Vol. III., Nos. 14 and 15. 



EDGAR AliLEN JONES. 455 

4. Dentsches archiv fur Klinisch Medicin, Bd. 67, 
Heft. 3 u 4. 
6. Edinbarg Medical Journal, Aagust, 1899. 

6. American Year Book Med. and Surg., 1898. 

7. American Year Book Med. 1900. 

8. Lamet, April 14, 1900. 



HYDROCEPHALUS, ITS ETIOLOGY, AND A 
CURATIVE OPERATION BASED THEREON. 



Bt Hbnbt Mitchell Huntkb, M. D., Union Spbinos. 
Senior Ck)un8ellor of the Medical Association of the State of Alabama. 



The discussion of the subject will be confined to that 
variety of the disease most often seen and known as 
Hydrocephalus Internus. 

The morbid process in this disease is usually chronic 
in character, but often takes on a sudden and very 
acute form; is nearly always congenital, though it oc- 
curs, even in adult life, as a sequel of meningitis, of 
syphilis of the membranes, etc., more frequently than 
is supposed by members of the profession who have de- 
voted little or no study to the subject. 

For obvious reasons, cases of the latter kind will not 
be embraced in this article. Hydrocephalus Internus 
is an over-accumulation of fluids within the ventricles 
of the brain, due, not to over-production, but to the 
want of means of escape. 

All serous structures secrete serous fluid, and it 
naturally follows that this secretion must, when it 
reaches the physiological limit, escape by some avenue, 
or, else, such structures as the ventricles of the brain 
will become over-distended with their own production. 

Leonard Hill demonstrated by experiment that a 
direct connection exists between the pressure of the 
cerebral fluid and absorption by the veins of the cere- 
bral membrane, that is, a ratio of equalization becomes 



456 HYDROCEPHALUS. 

established, by which the cerebral structure is protected 
from the evils of undue pressure. But, of course, this 
can pnly occur when the excess of fluid producing ab- 
normal tension has access to the membranes in which 
are the veins. 

A number of pathological lesions may^ and occasion- 
ally do, cause hyphocephalus by closing the foramen of 
Majendie and the apertures of Mierjejewski, but such 
cases, in advanced childhood and adult life, always re- 
sult from previous, definite, and, very often, recognis- 
able disease. The hydrocephalus of infancy, some- 
times originating before birth, often congenital and 
manifesting itself early after birth, or beginning undtf 
three years of age, will be discussed. 

Bruce and Stiles reported, in March, 1898, that in, 
practically, all cases of hydrocephalus Majendie's fora- 
men was closed and, also, every other channel through 
which the cerebral fluid in the ventricles might reach 
the sulHlural spaces. 

Watson, Cheyne, and Sutherland have, by post- 
mortem examinations, ascertained the same fact; they 
have also discovered that the foramen of Munro might 
be occluded. At the same time, they found in nearly 
all cases an absence of diseased conditions of the mem- 
branes themselves, and, also, an absence of the normal 
amount of sub-dural and sub-arachnoidal fluid, though 
the ventricles were enormously distended. 

Guided by the theory of Leonard Hill, fortifled, aa 
it was, by their own post-mortem discoveries, they de- 
termined to operate on an infant with a tremendously 
enlarged head, their purpose being to establish an open- 
ing between the lateral ventricles and the sub-dural and 
sub-arachnoidal spacs. 

Their flrst. operation was upon a six months' old in- 
fant, and was executed as follows: A curved incision, 
an inch and a half in length, was made over the left 
lower angle of the anterior fontanelle, embracing the 
skin and other tissues, down to the dura mater. This 
flap was turned down and, then, a small incision, one- 
fourth of an inch long, was made in the dura. No sub- 
dural fluid was present; a number of flne cat-gut 
strands, about two and a half inches long, were grasped 
with a pair of smooth, small, forceps, and pushed about 
an inch backward between the dura and the arachnoid^ 



HENRY MITCHELL HUNTER. 457 

while the other end was caught by forceps and pushed 
through the cortex of the brain into the lateral ventri- 
cles, when a clear fluid escaped in large quantities. The 
dura was sutured and the flap stitched back in apposi- 
tion; dressings were applied, and the wound healed in 
six days. There was over-lapping of cranial bones, 
due to the escape of the large accumulation of fluid in 
the ventricles. 

This fluid must have been absorbed, as Leonard Hill 
says, because the wound had healed in six days, there 
being no other way of escape. 

This child did not improve otherwise than from symp- 
toms of extreme pressure, died three months later from 
basilar meningitis, but an asymmetry was noticed, the 
left side being somewhat the smaller. 

They operated on a second case, with the same re- 
sult as to decrease of fluid ; the same asymmetrical con- 
dition was noticed, and they did a similar operation on 
the right side, which showed that it was necessary to 
drain both ventricles. This child was cured of hydro- 
cephalus, but its mind remained hopelessly impaired. 

I was impressed with the result of these ojjerations, 
and was convinced that they rested upon a correct and 
logical basis. 

I determined to do the operation whenever a suitable 
opportunity arrived. In July, 1899, I was called to see 
an infant, two months old, born at seven months, had 
been artificially nursed, and was suffering from gastro- 
intestinal disorder of rather severe type. 

The parents had not noticed any symptoms indicat- 
ing trouble of a hydrocephalic nature until one month 
prior to the date of my visit, yet, so rapidly had the 
disease progressed that when I saw the child the head 
was enormously distended, the bones were widely sepa- 
rated, and the pressure was so great that there was 
marked exophthalmos and total blindness. High fever 
and great restlessness were present; in fact, the child's 
condition was extremely critical. 

I made one curved incision, connecting the points of 
the lower external angles of the frontal fontanelle, instead 
of making two separate incisions, and turned the single 
flap down just far enough to give room for the other 
steps of the operation. I then made, on one side at a* 
time, an incision nearly one-half inch in length, througb 



468 H7DR0CEPBALU8. 

the dura mater, introduced three or four strands of No. 
oat^gut beneath the dura, about an inch, and then push- 
ed the other ends of the ligatures through the cortex 
into the lateral ventricles. 

There was no fluid in the membranous spaces, but 
when the forceps, carrying the ligatures, penetrated the 
ventricles, the fluid gush^ up like an artesian well. 

I closed the membrane, sutured the flap in position, 
and applied gauze dressing and bandages. The fluid 
continued to escape for three or four days. In a few 
hours after the operation, the bones of the head would 
meet, the child regained its isight, and the pressure 
symptoms were relieved. This improvement continued 
for six or eight weeks, at which time it was noted that 
the head began to enlarge again. This enlargement 
progressively increased until November 20th, when I 
was called to Pensacola, Fla., the home of the child, 
and performed a second operation. The child's condi- 
tion was as critical as at the time of the first operation, 
except there was no fever. 

I could account for the re-accumulation only from 
failure to establish a permanent opening between the 
ventricles and the sub-dural spaces, a result due, no 
doubt, to too rapid absorption of the very small liga- 
tures which I used in the first operation. I, therefore, 
decided to use five strands of No. 2 cat-gut. I modified 
the scalp-incision, because I saw no reason for such a 
large fiap. I made a straight incision, one inch long, 
over the lower external angle of the frontal fontanelle, 
down to the dura, incised that one-third of an inch, and 
inserted the ligatures of No. 2 cat-gut just as was done 
in the first operation. 

There was, again, an entire absence of fiuid in the 
sub-dural spaces, but the fiuid welled up as freely as 
before when the forceps penetrated the lateral ventri- 
cles. The dura was sutured, the scalp-incision was 
snugly closed and dressed with gauze and aseptic collo- 
dion. There was no escape of fiuid through the closed 
incision. When the child came from under the anaes- 
thetic the sight was found to be restored, as before. 
The head has never since become enlarged from over- 
accumulation of fiuid. The bones are still separated 
along the sutures and the fontanelles are unclosed, but 
there is positively no undue distension. The child was 



EENRY MITCHELL HUNTER. 459 

nourished after this last operation by a wet nurse, which 
markedly improved its digestion and assimilation. 

The health of the child is now perfect, its mind as 
bright and good as that of any child of its age, its body 
well developed, though the muscles of the lower extrem- 
ities are somewhat below par from non-use, and there 
is such improvement as to justify the hope of perfect 
recovery. In every other way the child exhibits evi- 
dences of perfect health, and bids fair to become as 
vigorous as other children less fearfully afflicted at the 
beginning of life. 

No other surgical procedure has accomplished enough 
in these cases to justify its repetition, or to win a recog- 
nized place in surgery. 

All other methods have been based upon empiricism. 

This operation produces no disturbance, is, in proper 
hands, free from danger, and corrects an abnormal 
condition, thereby removing the cause of the disease 
and rendering cure possible. 

Inasmuch as simple tapping or mere draining of the 
fourth ventricle and the later procedure of lumbar punc- 
ture have all been tried and found wanting, and even 
positively dangerous, there is unquestionably a brill- 
iant future for this operation. 

To gain, however, the full benefit of it, the operation 
must be done early, for, the chances of restoring the 
mind decrease with each week of delay in removing the 
pressure upon the cerebral structure. 



SOCIAL SELECTION. 

THB EXTIRPATION OF CRIMINALITY AND HEREDITARY 

DISEASE. 



By John E. Pubdon, M. D. 



A Sociological Branch having been voted on and 
adopted at the last general meeting of the Tri-State 
Medical Socitey of Alabama, Georgia, and Tennessee, 
held in Chattanooga in October last, the President was 



460 SOCIAL SELECTION. 

gcod enough to nominate me as one of the committee to- 
bimg the question of the intimate relation of medical 
and g^ociological matters before the members of tlie pro- 
fesbion in the State of Alabama, with the view of secur- 
ing their cooperation and support of the action of the 
Tr; State Society. Although I represented to Dr. Eamc 
that I was not at present a resident of the State, he 
was desirous that I should still continue my connection 
with the committee, and with this excuse for present- 
ing my views before you, and soliciting the forbearance 
and good will of my old associates, I venture to make a 
few introductory remarks on this important innova- 
tion. 

The subject of the marriage of criminals, epileptics, 
lunatics, consumptives, etc., being one of surpassing 
importance to the welfare of the race, and one that the 
Tri-State Society wishes to treat from the most com- 
prehensive p >int of view, I would suggest that marriage 
be first considered in its highest significance. I will 
add, however, that the Tri-State Society is in no way 
answerable for my personal opinions or method of 
treating the problem. 

Marriage is a failure, if regarded from the point of 
view of a mere sex congress. 

Satiety is the natural outcome of animal indulgence. 
It is an abuse of language to term such relation, 
marriage; for its true definition is the physical, social, 
and spiritual union of a man and a woman, who remain 
true to each other, in the hope of becoming one in God, 
when their executive function in the process of creation 
has faded away and a larger field is opened up to their 
expanding powers of thought, and their appreciation 
of the universal nature of life. 

The great source of danger in the present day is un- 
due haste: Marry in haste and repent at leisure — is 
truer now than ever. Unless a man and woman give 
themselves time to study each other's character there 
is always danger of a false judgment, based on passion. 
And, besides a reasonable time for the exercise of a 
more matured judgment, absence is a necessary factor 
to prove that the impression made in either instance 
is deeper than the surface. 

The more high-strained and nervous the subject, the 
greater the danger in a quick choice; for the easy 



JOHN E. PURDON. 461 

temperament, that soon comes to regard marriage as 
an affair of housekeeping, will submit to the disap- 
pointment of ideals that will be gall and wormwood to 
those in whom the Ideals still survive, in spite of all 
disappointment. Self-respect, that regards with horror 
the violation of what it deems most sacred in its rela- 
tions with another, is the true guide in the choice of a 
partner. 

The man or woman who knows that to meet and then 
to part leaves an indelible stamp of degradation on the 
soul, will always be careful not to run such a fearful 
risk ; but the light o' love that will meet and part, with 
a bow and an apology, or with a frown and a curse, is 
equally insensible to the true import of marriage. The 
religious sanction, in addition to the legal contract, is 
essential to the full realization of its significance. 

It will be thus seen that I draw a distinction between 
marriage in the higher sense of the word, and mating 
or pairing, which is essentially an animal function, 
and one which should be so understood and confined to 
its proper terminology. All right-thinking and right- 
speaking persons should strictly confine the term mar- 
riage to the human race; for only then is its spiritual 
import developed on an ascending scale. 

It is hardly necessary to say that the following sug- 
gestions have nothing to do with the life and conduct 
of those who, being blessed with the gift of continence, 
supported by strong religious or ethical convictions, 
voluntarily segregate themselves and lead a celebate 
life from choice — ^a noble choice — that we see so often 
exemplified in the cases of those, who, for the benefit of 
others, on account of social or family reasons, lead lives 
of self abnegation. These individuals are a law unto 
themselves — the law of the kingdom of God — ^and need 
no legislative interference. It is only out of respect 
to this class of the community that I make reference to 
them at all, for the purpose of guarding against pos- 
sible misapprehension. 

This being understood, the fundamental thought of 
marriage should be the improvement of the race, indi- 
vidually and collectively. 

If, now, it is an established fact that persons with 
diseased organisms generally have children whose 
bodies have a greater tendency to imi)erfection than 



460 SOCIAL SELECTION. 

good enough to nominate me as one of the committee ta 
biing the question of the intimate relation of medical 
and sociological matters before the members of the pro- 
fesbion in the State of Alabama, with the view of secur- 
ing their cooperation and support of the action of the 
Tr? State Society. Although I represented to Dr. Kimc 
that I was not at present a resident of the State, he 
was desirous that I should still continue my connection 
with the committee, and with this excuse for present- 
ing my views before you, and soliciting the forbearance 
and good will of my old associates, I venture to make a 
few introductory remarks on this important innova- 
tion. 

The subject of the marriage of criminals, epileptics* 
lunatics, consumptives, etc., being one of surpassing 
importance to the welfare of the race, and one that the 
Tri-State Society wishes to treat from the most com- 
prehensive p >int of view, I would suggest that marriage 
be first considered in its highest significance. I will 
add, however, that the Tri-State Society is in no way 
answerable for my personal opinions or method of 
treating the problem. 

Marriage is a failure, if regarded from the point of 
view of a mere sex congress. 

Satiety is the natural outcome of animal indulgence. 
It is an abuse of language to term such relation, 
marriage; for its true definition is the physical, social, 
and spiritual union of a man and a woman, who remain 
true to each other, in the hope of becoming one in God, 
when their executive function in the process of creation 
has faded away and a larger field is opened up to their 
expanding powers of thought, and their appreciation 
of the universal nature of life. 

The great source of danger in the present day is un- 
due haste: Marry in haste and repent at leisure — is 
truer now than ever. Unless a man and woman give 
themselves time to study each other's character there 
is always danger of a false judgment, based on passion. 
And, besides a reasonable time for the exercise of a 
more matured judgment, absence is a necessary factor 
to prove that the impression made in either instance 
is deeper than the surface. 

The more high-strained and nervous the subject, the 
greater the danger in a quick choice; for the easy 



J0H2J E. PURDON. 461 

temi>erameiit, that soon comes to regard marriage as 
an affair of housekeeping^ will submit to the disap- 
pointment of ideals that